Modern Scientific Controversies Part 3: The War on Sugar

Prologue: This is the third in a series of several essays that will discuss ongoing scientific controversies, a specific type of which are often referred to in the science press and elsewhere as “Wars” – for instance, this essay covers the War on Sugar. Kahan, in his recent “On the Sources of Ordinary Science Knowledge and Extrarodinary Science Ignorance”, refers to such controversies as “the Science Communication Problem” characterized by their “signature form of persistent contestation”. For the record, I admire Kahan’s analysis, but do not agree with it. The purpose of the series is to illuminate the similarities and differences involved in each of these controversies. I will share my analysis in an essay at the end of the series. Earlier essays in this series are here and here.

Warning: This is not a short essay. Dig in when you have time to read a longer piece.

“Our bodies need one type of sugar, called glucose, to survive. ‘Glucose is the number one food for the brain, and it’s an extremely important source of fuel throughout the body,’ says Dr. Kristina Rother, an NIH pediatrician and expert on sweeteners. But there’s no need to add glucose to your diet, because your body can make the glucose it needs by breaking down food molecules like carbohydrates, proteins, and fats.

“Some sugars are found naturally in foods, such as fruits, vegetables, and milk. ‘These are healthful additions to your diet,’ says Dr. Andrew Bremer, a pediatrician and NIH expert on sweeteners. ‘When you eat an orange, for instance, you’re getting a lot of nutrients and dietary fiber along with the natural sugars.”

“Although sugar itself isn’t bad,’ says Rother, ‘sugar has a bad reputation that’s mostly deserved because we consume too much of it. It’s now in just about every food we eat.” – NIH “Sweet Stuff”

I’ve bolded the central issue in the War on Sugar. The proponents of the War on Sugar – those fighting to eliminate — or at least sharply reduce the amount of – sugar from the American diet have painted sugar as bad – have made sugar into a villain – because it is too popular – people like it and, in the opinion of the anti-sugar advocates, eat too much of it. We should additionally note that sugars are one of the carbohydrates that the body breaks down into glucose – also known as blood sugar. This illogic – sugar is bad because we eat too much of it — is then used to vilify food producers who use sugar in their products – positioned as unnecessary, too much, wrong kind – an endless attack on a substance that is not only innocent, but is a necessary part of the human diet and the main source of quick energy for most higher life forms on earth.

The War on Sugar is dissimilar to the two previous Science Wars discussed so far in this series: The Salt Wars and the Great Barrier Reef Wars. In those previously covered wars, we found two groups of scientists, one on each apparent more-or-less polarized side of the issue, each surrounded by followers in civil society – activist groups, media, and citizens – who are also polarized on the issues involved. In the War on Sugar, we find almost exclusively a large monolithic body of science and health researchers, ‘science popularizers’ and government agencies waging an endless battle against what they see as the inertia of the general public – who for the most part refuse to do as they are told and give up, or at least eat less, sugar — and, as is common in science wars, assert that there is a conspiracy called Big Sugar (which includes all food producers and anyone else not aligned with their view).

The anti-sugar forces use logic like this: “Several studies have found a direct link between excess sugar consumption and obesity and cardiovascular problems worldwide,” Bremer says. Because of these harmful effects, many health organizations recommend that Americans cut back on added sugars.” (NIH – ibid)

All of us who have studied and trained ourselves to read health studies and findings see right away the problem here. The finding of “links” (direct or not) between two or three things is [almost] meaningless. To then make society-wide health or diet recommendations on this sort of weak evidence is not scientific.

As in both of the previous wars, we find that the War on Sugar, has at its core a simple and basic truth, with which most people would agree is true (or, more precisely, true enough). All sugars have high caloric values – they are loaded with calories, packed with chemical energy. [Simplification Warning – the following is actually far more complicated, but this will suffice for now.] In a very general sense, human bodies need to take in as much energy as they expend – they operate on an energy budget. If one expends more energy than one takes in, the body starts using itself as an energy/food source. It begins breaking down its stored fat and uses it for energy. If it runs out of fat stores, it begins to break down the fabric of the body itself – one is starving. On the other hand, if one takes in more energy – more calories – than one expends, then the body stores the extra energy by converting it to fat – its ready pantry of food storage – which can be used later if needed.

The current public health view is that all “excess body fat” is bad, bad, bad – a view that ignores the incontrovertible evidence that so-called overweight people live the longest compared to so-called normal weight and obese people– a fact named The Obesity Paradox.

It is well established that the morbidly obese – those with body mass indexes exceeding 35 or so – are prone to a bevy of health problems which include diabetes and cardiovascular problems associated with high blood pressure. It is not yet entirely clear what type of comorbidity exists between obesity and the related health problems – the choices being: direct causation, associated risk factors, heterogeneity, independence – but the general view is that obesity is either a direct cause or a very high risk factor and thus, if there were less obesity, there would be fewer cases of diabetes and heart disease, a win for individual health, public health and a savings in health care costs.

Thus, the current prominent public health view that eating sugar leads to weight gain which can lead to overweight which can then, if the trend continues, lead to obesity which is a risk factor for diabetes and heart disease – therefore: Eating excess sugar must stop.

The basic truth is that people who are concerned about unwanted weight gain, who are dangerously overweight or who have problems related to the body’s sugar-processing functions, should consider reducing the overall calorie intake – with sugars, particularly added sugars, being the easiest calories to identify and reduce.

If this were The Public Health Message About Sugar all would be well – there would be no controversy and no need of a science war. This true and accurate health message has apparently – see the rising tide of obesity – failed to convince, or failed to help, those to whom it is rightly addressed. The “chain-of-evidence” indicting dietary sugar as the [or even a] cause of diabetes or of high blood pressure or of obesity and related heart disease involves way too many “can lead to”s – the evidence itself is weak.

It is because the evidence is so weak that anti-sugar forces, which include the FDA (plus the usual cadre of health food and health fad advocacy groups), must rely on exaggerated framing of the evidence in order to justify their policy recommendations.

In a nutshell: The claimed basis for the War on Sugar is that sugars – particularly added sugars, a phrase used to avoid indicting fruits, fruit juices, sweet vegetables and milk – are “empty calories” that when ingested in excess can lead to weight gain which can then lead to diabetes, metabolic syndrome and cardiovascular disease.

[ It might be well to point out, as an aside, that when I was in hospital following a heart attack, the nice nurse, on orders from my doctor, plugged a tube into my arm that fed me normal saline solution (salt water) laden with dextrose/glucose (sugar) – those vilified “empty calories” – to sustain my life while I was unable to eat other foods. ]

On the same advice page from the National Institutes of Health, the conclusion is given as:

“In the long run, if you want to lose weight, you need to establish a healthy lifestyle that contains unprocessed foods, moderate calories, and more exercise,” Rother says. [Dr. Kristina Rother, an NIH pediatrician and expert on sweeteners]….

“The key to good health is eating a well-balanced diet with a variety of foods and getting plenty of physical activity. Focus on nutrition-rich whole foods without added sugars.” [emphasis mine – kh]

The majority of this conclusion is scientific and based on good research that returns useful information to nutritionists who have translated it into good clinical advice. The emphasized words and phrases are advocacy and are only very vaguely based on science at all.

There is no evidence, given a well-rounded diet, that “unprocessed” foods are more healthful than processed foods or that well-rounded diets should focus on “whole foods” (a marketing term, not a scientific term) and foods that are free of added sugars.

By the way, the science expressly states, contrary to common belief, that sugar consumption, even excess sugar consumption, does not cause diabetes. (WebMD, supplier of the video making this point, is apparently so sure of the opposite opinion that they named the video file “kahn-eating-sugar-cause-diabetes”.]

Back to Earth: None of these facts should be taken to mean that I, or anyone else, would not suffer health consequences if I ate nothing but ice cream, sugared donuts, honey-sweetened smoothies, drank liter-after-liter of full-sugar soft drinks or chug-a-lugged can-after-can of sugar-laden, over-caffeinated energy drinks alternated with Snickers and Mars bars. That, my kind friends, does not a well-rounded diet make. As with all things, the poison is in the dose, and sugars, as with every other type of food, probably have some natural limit.

“If every candy bar and soda across the country carried a warning label just like a pack of cigarettes does, then our country would start to see our sugar consumption go down, just as we have been able to see it happen within the Tobacco industry.”

“Nutritionists frown on added sugar for two reasons. One is its well-known links to weight gain and cavities. The other is that sugar delivers “empty calories” — calories unaccompanied by fiber, vitamins, minerals, and other nutrients. Too much added sugar can crowd healthier foods from a person’s diet.”

AND BOOK TITLES:

Sweet Poison: Why Sugar Makes Us Fat by David Gillespie

Suicide by Sugar by Dr. Nancy Appleton

Sugar Nation: The Hidden Truth Behind America’s Deadliest Habit and the Simple Way to Beat It by Jeff O’Connell

The Sugar Addict’s Total Recovery Program by Kathleen DesMaisons

The Real Truth About Sugar: Dr. Robert Lustig’s “Sugar: The Bitter Truth” by Samantha Quinn

Sweet Pete: A story about a bunny who ate too much sugar (a children’s book) by Maria Alony and Heidi Rodis

Sugars and Flours: How They Make us Crazy, Sick and Fat, and What to do About It by Joan Ifland

[ Disclosure: I have read all the articles linked, plus approximately 100 others, as well as dozens of journal articles on the sugar issue, but have only read one of the books: Sweet Pete: A story about a bunny…. ]

“Sugar is poison” (Dr. Lustig and others), “sugar is killing or will kill us”, “sugar is like tobacco”, “sugar makes us crazy”, “sugar is addictive (like cocaine or heroin)”.

These are not the messages of calm, deliberative nutritional science. They are wild and unfounded exaggerations, unlikely extrapolations, symptoms of “public health epidemiology” and the inevitable propagandists’ tool, “sugar is the first step on the slippery slope to morbid obesity, metabolic syndrome, diabetes, and eventual death from heart disease.”

Who, you may rightly ask, is on the side of rationality in this controversy? Very few, and far between.

In this War, we see industry forces whose profits depend in part on high-sugar content foods and drinks funding research in hopes of clarifying the science. Regardless of the findings, the strength of the science, and the thoroughness of the methods, industry science is discredited and discounted.

There are a few voices that occasionally fight back against the exaggerators – write articles pointing out that sugar is not poison, for instance, Ross Pomeroy and David Katz among them. Those who are too outspoken are accused of working for Big Sugar.

The War on Sugar is intertwined with the Obesity Wars, the Soda Wars and HFCS Wars (a sub-set of the War on Sugar).

But we see some common features with the two previously discussed Wars: there is polarization among scientists and the general public, there is resistance to those changes in public policy being insisted on by those speaking for Science, when evidence is weak or only associational, proponents of policy change have exaggerated risks and inflated expected benefits of proposed policy changes to make their messages more powerful (but less true), the general public may pay lip service to the messages (many say they are avoiding sweets) but does not change its behavior (sales of sugar laden StarBigBucks coffee continue to soar, so-called energy drinks – contents: sugars and caffeine — have grabbed a huge bite of the canned drinks market, US candy sales increased from 6.8 billion dollars in 2009 to 8 billion dollars in 2014).

As of 2015, the combined billions of dollars of research expended on the sugar question have allowed us to reach this conclusion:

“Conclusion: There are epidemiological data, plausible mechanisms and clinical data from diet intervention studies that provide strong support for a direct causal/contributory role of sugar in the epidemics of metabolic disease, and for an indirect causal/contributory role mediated by sugar consumption promoting body weight and fat gain. Yet, these are still controversial topics.” Kimber L. Stanhope (2016) Sugar consumption, metabolic disease and obesity: The state of the controversy, Critical Reviews in Clinical Laboratory Sciences, 53:1,52-67 DOI: 10.3109/10408363.2015.1084990

Medical/Nutritional science has made the long, long loop back to where it stood 40 years ago: sugar, representing calories, may cause or contribute to ‘metabolic disease’, meaning 3-out-of-5 of obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides, and low high-density lipoprotein (HDL) levels. [NB: Metabolic syndrome is associated with the risk of developing cardiovascular disease and diabetes.] and may indirectly cause or contribute to “promoting body weight and fat gain”.

Overeating, over-consumption of calories beyond your energy expenditure may cause you to gain weight and, if you do become too heavy, too fat, it can adversely affect your health. This we already knew.

The policy proposals that the general public must be somehow forced to reduce their intake of sugars, through FDA nutritional advice, pressure on the food industry to reduce added sugars, through outright propaganda aimed at the public, and through attacks-by-regulation (so-called soda taxes) on the sugared-drinks industry are all based on the premise that if the public consumed less sugar they would be less fat and more healthy – yet another “one substance solution” which is almost certain to be only a part of the problem that is as yet only vaguely understood. Policies to enforce the premise as a society-wide solution to obesity or metabolic syndrome or diabetes are most likely to fail because they do not solve the right problem and the general public will not act on such weak evidence of potential harms. The general public recognizes the “advocate that exaggerates” as an untrustworthy source of information and discounts all his advice, rejecting the good along with the bad.

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Author’s Comment Policy:

I have personal experience with added calories – if I drink highly-sugared beverages and eat primarily restaurant food – which I did for months at a time when traveling for business, staying in hotels, in the 1990s – I put on 10-15 pounds of extra weight. I knew it would happen, but one pays the price of doing business. On return home, to home-cooked meals and more choices, I readily dropped the extra weight. The cycle was repeated several times. I am now, as I have habitually been, a perfectly normal-weighted middle-age-shaped man, with a current BMI of 24. I have a sweet tooth and childishly enjoy a bit of candy or a dish of ice cream occasionally. I don’t have any stake in the War On Sugar, with the exception of my concern for the extent of the harm that these modern scientific controversies do to the reputation of science.

I will be glad to answer your questions about the War on Sugar – I have been following it for at least 15 years.

I realize that many readers here will want to move on immediately to discuss the parallel problems in the Climate Wars. I ask that you please try to restrain yourselves – we’ll get to that later on in the series.

I am still open to suggestions on which of the current Science Wars to cover in this series, I am aware of a half dozen or more. I have more-or-less promised to cover the Ozone Wars dealing with the so-called hole in the ozone layer.

The last essay in the series will be an attempt to layout a coherent pattern of modern science wars and maybe suggest ways that the different science fields themselves can break these patterns and return their specific area of science back to the standards and practices that should exist in all scientific endeavors.

301 thoughts on “Modern Scientific Controversies Part 3: The War on Sugar”

The mainstream medical opinion is all wrong about type 2 diabetes, confusing cause and effect. There is a growing group of researchers and doctors who now understand that… drumroll please… insulin causes insulin resistance.
You can get started here: https://intensivedietarymanagement.com/

Thank you for this link.
From a recent article there regarding a study on ketogenic low-sugar, low-carb diet: “The award winning science journalist Gary Taubes believes that obesity is essentially a disease of too much insulin – hyperinsulinemia. Since refined carbohydrates stimulate insulin more than fat or protein, reducing said carbs will result in greater fat loss.” Further on, “Over the 4 week KD [ketogenic low-carb, low-sugar diet], yes there was fat loss. There was an initial period of greater weight loss which all agree may be some diuresis. We can also agree that insulin levels were brought down by the KD. Secondly, using measures of EE [energy expenditure] there was an increase in calories burnt. Those are all facts, not opinions, derived straight from the study.” https://intensivedietarymanagement.com/heres-5-kevin-hall-go-buy-clue/
Unfortunately, the author of the study spun it around to fit the politically correct narrative. Similar to how the climate change evidence is spun.
Atkins diet works to lose weight because it reduces carbs from the equation – like sugar, white flour (cheap bread), soda pop. This should be a no-brainer. It’s not meant to be “high-protein”, this is a confusion. (Atkins didn’t die of a heart attack, as the urban myth that is circulated by anti-Atkins people. He slipped and hit his head.)
The kidneys can’t handle too much protein. This is why an Atkins diet should include plenty of fat, which aids in protein digestion. Fatty meats, not lean meats, are then recommended, such as maybe eggs, avocados, cream, lobster and butter, steak with bone broth based steak sauce, for example. Bacon should not be lean but fatty, if one eats bacon (I love bacon on occasion and use it with other food combinations).
The Atkins program removes all carbs at first and slowly reintroduces them, especially vegetables. It works to lose weight.
The “new” Atkins mentality is to avoid saturated fat like the plague, more politically correct spin. The heart’s two favorite foods are stearic and palmitic acids, both saturated fats found in meats, goose fat, coconut oil, palm oil and others, according to Dr. Mary Enig, who was a lipid researcher and co-author of Nourishing Traditions and also Know Your Fats.
So saute those veggies in traditional fats like the French and use duck or goose fat and butter. I use coconut oil, butter and avocado oil commonly to saute veggies and cook in bone broth. A couple teaspoons of some kind of healthy fat is about all that is needed, I find. I then add fermented fresh-ground grain batter to make gravy, then add some cream, an egg and then dash of curry. Delicious, warming, satisfying and no meat at all.
Grains should be sprouted, soaked or fermented to make them more digestible and remove anti-nutrients like phytates. One egg per day satisfies most of the protein needs, unless you work out or do a lot of physical labor. One 3oz piece of pasture-raised liver will provide lots of vitamins. Combine with grilled onions, goat cheese, avocado and favorite veggies, topped with favorite low-sugar sauce like hot sauce or dash of spicy mustard for a delicious nutrient dense low-carb meal.
The point is that fat can replace refined sugar in a low-carb diet more so than protein. Fat provides satiety, reduces sugar cravings. We love fat. A little goes a long way. So why do we feel guilty eating it? It’s been shunned for years and the idea, like “global warming”, is forced upon us by a corrupt scientific system that is based mostly on profits, in my opinion. Fear of natural fat leads to more carbs in the diet and also tends to encourage use of highly processed oils like Canola and other cheap vegetable oils. Polyunsaturated fats are more likely to go rancid and cause heart lesions than natural saturated fats.
In the end, regarding the article, I don’t believe in a war on sugar or banning soda pop. That’s the AGW way to do things. But educating people on the facts of the matter might be helpful for people to change their dietary habits toward a more nutrient dense way of eating that will reduce collective national healthcare costs into the billions of dollars, I believe. I have learned much from the Weston A. Price Foundation and Nourishing Traditions by Sally Fallon and Dr. Mary Enig. It has changed my life and saved my health, I feel.

What it comes down to is the ethics of lying to the general public in the pursuit of a “worthy cause”. My personal opinion is that lying is ultimately stupid, but often successful in the short term. There is, of course, the cynical statement by an economist that in the long term we are all dead.

(1) “Health” is the new secular morality. S/he who can mortify their flesh the most impressively, giving up all pleasures and the no-no of the moment, wins virtue-signaling points.
(2) “Calories in, calories out” is a piece of simplistic late 19th-century reasoning that has been debunked thoroughly many times. All calories are not created equal. Carbohydrates cause the secretion of insulin, which governs the storage of fat. You can eat fat until you go blind without gaining an ounce, as long as no carbohydrates (including sugar) are in the picture. This has been known since the time of Banting.
(3) Always follow the money. The point is a “sin tax” on something people want badly, but do not NEED.
Let’s face it, if they taxed kale, nobody’d ever eat the stuff. Come to think of it, nobody ever did anyway until it became a virtue-signaling fad.
(4) As per a recent article posted here, ALL the major “diseases of civilization” are in decline, particularly among the advantaged classes, and a little extra girth in middle age is not adverse. “BMI” is an arbitrary construct with no scientific validity (it was invented by an astronomer with an interest in averages, not health) and the designation of “3 out of 5” of us as “too fat” is an arbitrary social construct as well.
(5) There IS no “crisis” in public health, except that too much crap is being done, too expensively, to the “worried well” with no problems, while the lowest socio-economic quintile is allowed to fall through the cracks (since unprofitable to treat) with their ill health being blamed on their own “bad behavior.”
Many thanks for this article!

Eating fat requires the release of insulin—every food does. Insulin is what allows the glucose into the cells. Fat digests to glucose—all food does as the glucose is what the cells use. There is a tendency to tell diabetics now that fat and protein “don’t count’ but they do. Both can raise blood sugar. If fat did not require insulin, diabetes could just eat fats and not die.
It is interesting that the primary function of insulin is to break down food into glucose for the cells and now we believe it’s wrong and evil to have insulin do just that. The current thinking is everyone should live like diabetics did before the discovery of insulin, avoiding all carbs. Insulin should never be used? Is there a limited quantity? I’m serious here—it makes no sense to me and never has. Non-diabetics produce insulin and are told to pretend like they don’t. Why?
I agree that we have over medicalized things, but you’re making overly simplistic declarations about insulin and sugar.

Good post, except for this bit:
“(2) “Calories in, calories out” is a piece of simplistic late 19th-century reasoning that has been debunked thoroughly many times. All calories are not created equal. Carbohydrates cause the secretion of insulin, which governs the storage of fat. You can eat fat until you go blind without gaining an ounce, as long as no carbohydrates (including sugar) are in the picture. This has been known since the time of Banting.”
First off, it’s interesting that you would dismiss calories in/calories out as being simplistic and outdated, while ending the paragraph with a concept that is simplistic and outdated. Relying on the casual observations of a 19th century layman like Banting doesn’t tell an informed scientific story. A careful look at Banting’s diet finds, along with lower carbs, lower calories. He didn’t compare his low carb diet with other attempts at calorie reduction. We can’t attribute outcomes to one of multiple variables until we control those other variables.
I did the same thing the first time I had to lose weight: I went low carb and lost 60 pounds. I attributed my success to my carb reduction. I went on to put half that weight back on. What to do now? I had no interest in going back to low carb, because after my initial excitement with success, it wasn’t a sort of diet that I could live with long-term. I was destined for the stereotypical dietary yo-yo. I then tried intermittent fasting. SUCCESS! So I attributed it to the metabolic mythology that some IFers claim. I eventually had the epiphany of reality: it’s calories in/calories out. My low carb diet worked because I reduced my calories. I received my needed nutrition with less food and fewer calories. And let’s face it: when you go low carb like I did, there ain’t shit left to eat between meals. One can only snack on so much beef jerky. Intermittent fasting worked because my overall calorie intake was down.
I now eat whatever I want. I make homemade desserts and eat them every day. Pie, pudding, cake . . . every day. If I run out of dessert, I’ll go out for ice cream. I just happen to keep my overall calories in check via the amounts that I eat along with vigorous, daily exercise. I weigh the same now that I did 35 years ago and I’ve maintained this weight easily and comfortably. It’s about finding a diet/lifestyle that we can live with in the longterm, and that involves something more than the relatively short-term excitement of dietary fads. Are my observations just more casual anecdotes? Could be. But they’re backed by the best of studies that actually control for every calorie of their participants.

The problem with much of the research is that it is nearly impossible to conduct unbiased research given the difficulty of controlling food intake for humans. Different types of food have different effects on the human metabokism and that varies from human to human.

That is very true, especially the variability between individuals. This is why biology is a science (looks at generalities) while medicine (including diet) is an art, the application of a science to a particular case.

I admit i didn’t “dig in” regarding sugar.
But it reminded me of a local scare the EDF tried to raise about atrazine in our local water.
To make a long story short, they took one sample at one tap. The results were above the EPA Maximum Contaminate Level. They raised the ALARM!
In the alarm they reported chronic effected as if they were acute. It gets worse.
They neglected to report that the MCL was based on an annual running average, not a single sample or spike. The MCL here was never exceeded. They just made it seem like it was.
They also neglected to mention that if a person drank water with atrazine at the MCL everyday then after 70 years or so they’d have a 1% increased probability of developing some form of cancer.
(I don’t remember if they’d have to drink 5 or 50 gallons of water a day. But I think you get the point.) Whatever the issue, some seek a headline to inflate their point, however dull it may be.

What was going on around there at the time? Here, they pulled the same thing with a barely over the limit zinc reading, at only one wellhead – when they were pushing to get the Central Arizona Project water approved down here.
It worked. And I’m pretty sure that more health damage was caused by the crud flushed out of the ancient distribution system when the chemistry was radically changed than would have been in a millennium of drinking from that one well that was out of compliance.

Are you sure it was zinc? Zinc is hardly toxic at all – certainly it ties with bismuth the least toxic of the heavy metals. People buy zinc pills to help offset the effects of the common cold (didn’t work for me though). Calamine (zinc carbonate) lotion is helpful for treating skin irritations, and zinc-rich ointments are used to treat diaper rash in babies. IMHO, a bit of zinc in your water is probably a good thing.

It was around the mid-90’s. I was relatively new to the area. But I do know this. The city government hadn’t gone “Green” yet. They actually fought back with facts. (I miss those days.)
PS It think it may have been the EWG (Environmental Working Group) and CA (Citizens Action) rather than the EDF (Environmental Defense Fund) in the forefront.

This also involves the major dispute about linear or threshold effects. EPA always assumes linear, all biological evidence suggests there are thresholds below which there are no discernable effects for most exposures. Radiation exposure, many chemical exposures, and second hand smoke exposure all involve this fundamental ‘war’ about significance. The linear model says the EPA is never done. The threshold model says there comes a point when they are done. The institutional bias toward bureaucratic preservation is self evident.

Reply to ristvan ==> All true — there is the additional factor of “runaway epidemiology” — in which massive databases of questionable accuracy are mined for links and associations with problems. The resulting links reported are generally such tiny differences that causation is certainly lacking — yet the links are treated as if they were something that must be dealt with clinically. (Some links may be proper subjects for further study.)

Great post, Kip. Thanks. As a “sugar daddy” I have always felt guilty of eating and enjoying sweet goodies with the certain belief that it would catch up with me in the end but so far, so good I have retained normal weight and shape yet my craving for sugar continues to be indulged.
It helps enormously with my climate scepticism.

Ideally your carbs should provide high nutritional density and low glycemic load. Sugar (and most grains) are opposite that with sugar being the worst as it has almost zero nutritional density and a high glycemic load. At the opposite end of the spectrum you have green leafy stuff. The highest nutrient density and a GL so low they had to estimate it.
Dr Sears has been explaining it with his Zone Diet series for a long time. Check it out. It does not exclude you from ever having sugar or wine/beer. You try to limit the unfavourable carbs to 1/4 of you meal’s carb content. Keep in mind one can of pop has a full meal’s worth of carbs in it. It is very dense and easy to overdo.
Interestingly the research at Harvard Medical School on GL shows that ordinary table sugar has a lower GL than most grains. Most table sugar is a mix of glucose & fructose so the fructose gets absorbed much slower. Grains are mostly glucose molecules held together with a weak oxygen bond. When that hits the stomach the bond breaks easily releasing all the glucose.
Another interesting fact about GL is that it is the soluble fibre which slows the absorption into the blood stream and only oats & barley have any significant quantity of that. And not oatmeal, we are talking whole or steel cut oats.
If your diet has a high GL then your glucose levels spike after a meal and your body releases insulin to bring it back down. If you have a low GL meal the glucose goes into the bloodstream slowly and evenly over time.
Good health to all of you.

I applaud TRM for his calm response to this article, I’m not feeling so charitable but I’ll try to keep it cool.
First off, I hope everyone understands that nutritional research is as bad or worse than CAGW research and has been that way ever since Ancel Keys took us down the road of demonizing fat back in the 1950s. I always equate Keys to Michael Mann, same bad studies and same domineering personality, both of which set back research in their associated fields for decades.
Second, if there’s one thing you should understand about nutrition and health is that people who say a calorie is a calorie regardless of the source don’t know what they don’t know. The idea that you can lose weight by eating less and exercising more seems logical on the surface but it’s dead wrong. Fat storage is dominated by the hormone insulin (any biochem textbook will tell you this). High blood sugar provokes your pancreas to increase insulin production and that excess blood sugar is turned into fatty acids and stored away by insulin. If you eat foods that your body metabolizes into glucose at every meal then you will have high insulin levels all day, which not only stores fat but also keeps it locked away, preventing you from using your stored body fat for fuel. Your body responds by making you hungry. People with chronically high insulin levels may be eating a lot but could be starving at the cellular level. Show me an obese person and I will show you a person with either a damaged thyroid or more likely severe insulin resistance. Starving yourself or exercising for hours every day rarely works in the long run because the underlying issue, high insulin levels, aren’t corrected and any attempt to lose weight these ways will result in severe hunger or a retarded metabolism, both of which will lead to yo-yoing body weight. Most of you have probably dieted like this – I bet you were able to drop some weight but then you plateaued and the weight came back, with interest. Get the insulin down with a low carb diet and the weight falls off.
Now if you believe that the source of your calories doesn’t matter when it comes to body fat, that a calorie is a calorie, then I would like to direct you to Ancel Key’s own study on the subject – The Minnesota Starvation Experiment. I’ll skip to the result – it was discovered that creating a similar calorie deficit in a number of individuals led to different amounts of weight loss. If a calorie is a calorie and a 3500 calorie deficit would lead to 1 pound of fat lost, why did all these people have disimilar results. Since Zoe Harcombe did an excellent post on this study I’ll link to it if you’re interested (and I hope you are) rather than write more about it.http://www.zoeharcombe.com/2009/12/the-minnesota-starvation-experiment/
I appreciate the effort Kip puts into these articles but in this case I’m having a lot of trouble swallowing what he’s saying. and quoting Web MD isn’t making it any easier. Sugar is hazardous and not simply because it’s empty calories.

I agree completely Bob with your post about dietary sugars and insulin. Nowhere in Kip’s essay did he mention insulin. It is far too complex to discuss insulin signaling pathways and Insulin-like growth factors (IGFs) intersections with those intra-cellular biochemical pathways. Much is not known about mechanisms of insulin signaling on diverse tissues. But what is clear is insulin and insulin-like factors that signal in insulin pathways shorten your life.
Message for all here: Chronic. Insulin. Signaling. Shortens. Your. Life. Period.
And dietary sugars force your pancreas to secrete copious amounts of insulin to control glucose levels in the blood.

Amen, Bob. Most people can’t get over their early training that insulin is required “to get glucose into cells.” It’s real physiologic function is to stimulate lipogenesis and inhibit lipolysis. (The kidney is the only organ that requires insulin for proper metabolism.)
BTW- diabetes (a term really not much more specific than “infection” as a diagnosis) is a classic example of the interaction of Nature & Nurture. To show elevated BS levels, one must first have the appropriate genotype(s) and then be exposed to excess dietary carbs. Excess carbs do not “:cause” diabetes by themselves. In treating diabetes, no pharmaceutical intervention will be effective unless an appropriate curtailment of dietary carbs is followed.

I agree heartily on Web MD. I once contacted the editor to protest about a dangerous oversimplification regarding ways of reliably neutralizing parasites in seafood, and got the bum’s rush.
I wasn’t aware of some of the information in your comment, and appreciate it, but I’ve noted some other glaring defects in the Original Post:
1. the characterization of “almost all” anti-sugar advocates as raving paranoiacs:
“In the War on Sugar, we find almost exclusively a large monolithic body of science and health researchers, ‘science popularizers’ and government agencies…[who] assert that there is a conspiracy called Big Sugar (which includes all food producers and anyone else not aligned with their view).”
2. The invocation of the BMI, one of the bluntest tools in the medical bag, and unscientific pontification “it is well established that”:
“It is well established that the morbidly obese – those with body mass indexes exceeding 35 or so – are prone to a bevy of health problems which include diabetes and cardiovascular problems associated with high blood pressure. ….”
(full disclosure – my own fat density measured recently at 8% by the gold standard imaging technique, and yet have a BMI in the low 30s)
3. And the failure to clarify the most puzzling aspect of the sugar indictment – that “natural” sugars are OK, only the processed ones are a danger to human health. It’s obvious to me that brown and black bears manage to get very, very fat by gorging themselves on berry sugars in the Fall, and manage that without ever consuming processed sugars. So I would deduce that a human being consuming the same quantity of fruit would get just as fat.
And why don’t the bears suffer from diabetes and cardio-vascular disease?
As for other scientific “wars” deserving to be pacified – I would suggest the War on Radon. It is based on an unscientific assumption by the EPA, the WHO, and Health Canada, among others, that the toxicity of Radon daughters is linear, and totally ignores the concept of hormesis, well known and accepted (sometimes very belatedly) in the case of other trace elements in our environment, such a selenium.
I have not been able to get access to the original studies, but have read that experiments with lab mice in the 1950’s demonstrated that those that had all Radon removed from their food, water, and air lived only 66% as long as the control group.
It has also been reported in the mass media that people suffering from serious osteoarthritic pain reported being relieved of their pain for several months after spending a few hours in decommissioned Radon mines. I’ve not been able to get access to any of the scientific reports on that either. But have seen video documentaries suggesting that such visits have been commercially organized and regularly scheduled in the past.

“If your diet has a high GL then your glucose levels spike after a meal and your body releases insulin to bring it back down.” Uh, that is the function of the pancreas and insulin. It’s an argument that basically says if you use anything too much, it fails. I fail to see how a normal bodily function doing what it is supposed to do causes the failure of the organ. Eating low sugar means the pancreas can fall asleep and fail to wake up by your logic. If you don’t use, lose it?
Are you then blaming baby boomers for their joint replacements because they were too active and they deserve to destroy their body for abusing it? Extreme athletes should be outlawed? Where do we draw the line? Is there any consideration of individuals or are we all just an average?
There’s a fine line at which use becomes abuse. How much sugar? No one knows. Thanks to all this sugar demonization, we have pediatricians telling 5-year-olds they can’t eat sugar or they’ll get diabetes and have to take shots. Years were spent teaching people diabetes, type 1 specifically, was NOT due to sugar intake. Now the blame game is back and 5 year olds are mocked as being responsible for their auto-immune disease because they were evil and ate sugar. It’s a punishment from God, or nature, or whatever. This is not helpful.
There are skinny, type 2 diabetics who ate healthy food. There are very obese people who never develop diabetes. Cause is always 100%, so the sugar is NOT the only cause. There are multiple factors, all those not including sugar are simply dismissed.

“There’s a fine line at which use becomes abuse. How much sugar? No one knows.”
Actually it’s pretty easy to tell. Get some testing done, even a basic lipid test and blood pressure check will tell you. The thing I look at the most are the 5 factors that make up a condition called Metabolic Syndrome. If you have three of the following five risk factors you have Metabolic Syndrome. A low carb diet is shown over and over to reduce all of these risk factors w/o the use of drugs. And personally I’d be concerned if I had even one of these risk factors.
1. Abdominal/visceral fat – Are your pants tight? Do you have a belly? This is bad fat. It’s not necessarily a cause of heart disease and other maladies, it’s simply a marker.
2. High blood pressure
3. High triglycerides – This is normally classified as anything over 150 mg/dl but personally I’d say anything over 100 mg/dl is concerning.
4. Low HDL – If you’re a guy anything under 40 mg/dl is concerning. For women anything under 50 mg/dl is the cutoff.
5. High fasting blood sugar – Doctors say anything over 100 (I say anything over 85). Now I take exception with this one because it can take a decade or more for insulin resistance (what they’re trying to measure with this test) to show up in an abnormal fasting blood sugar reading. Much better to look at fasting insulin levels or better still to take an oral glucose tolerance test with an insulin assay to really see what’s going on. A simple fasting blood sugar test is going to give you the best case reading (insulin has all night to drive those sugar levels down) and that’s not really informative.
Just these 5 risk factors will give you a very good idea of your overall health as Metabolic Syndrome is highly associated with every chronic disease man suffers from today. And taking drugs to lower these markers isn’t actually helpful, treating a marker doesn’t treat the underlying cause. An example of why it’s dumb to treat risk factors would be to look at gray hair. People with gray hair are at higher risk of death. Do we give hair dye to these folks? That’s the thought process when someone is given a Metformin or beta blockers or statins. It’s an assumption that the marker is the actual cause. They’re most likely not. You want risk factors to be normalized not by drugs but by lifestyle changes like diet and exercise (weight lifting is terrific). And it’s been shown time and again that a low carb diet and/or intermittent fasting are both great ways to get these risk factors headed in the right direction naturally. A low fat/high carb diet generally worsens them.

Metabolic syndrome is a group of so-called risk factors. It is not a disease and can be modified by anyone who wants to include anything one wants. In other words, it’s a made up thing to scare more people.
Of course it’s associated with every with every known chronic disease humans have—so is having blood, but that doesn’t make it the cause. It is amazing how we have been taught that correlation IS causality. It sells so very, very well. Also, it shows us that science has reverted to the witch doctor and gypsy wagon levels where people still buy that magic tonic and think the vapors are caused by being female. It terrifies me how dead science is and how alive magic and superstition are.

Metabolic syndrome is a group of so-called risk factors. It is not a disease…
Am I the only one who hates it when someone paraphrases exactly what you said but makes it seem like they’re the one coming up with the idea?Of course it’s associated with every with every known chronic disease humans have—so is having blood, but that doesn’t make it the cause…
Is reading for comprehension difficult for you? I never said it was the cause, in fact, I went out of my way to make sure nobody would mistake a risk factor for a cause.
You asked the question (which I think you assumed was rhetorical but it’s not) as to how much sugar is too much and I responded with how people can know, by checking to see if they have the Metabolic Syndrome. Get over it.

There ARE going to be repercussions for “extreme atheletes.” Even moderate ones. It’s filling orthopedic wards all over the US and UK, and doctors are calling it “Boomeritis.” We Boomers are the first generation to attempt retaining significant athletic performance post-college age. As a result, we are accumulating a set of joints, tendons and ligaments that look no different from the age-related degeneration afflicting the field full of retired race and showjumping horses I take care of every day. Why would we be different?
“Extreme” athletics, including fad gym workouts like CrossFit and ToughMudder, not to mention running marathons etc., will ultimately be found to be aging people’s musculoskeletal frame prematurely–not unlike the NFL or NBA stars whose careers have a short shelf life.
Eliminate our culture’s mortal terror of aging and putting on weight, and who in their right mind would want to do these things anyway? Frankly, extreme exercise makes you feel like shit!

Bob Johnston: You called it a “condition”. I did not interpret that as “a group of risk factors strung together”. You stated you’d be concerned if you had even one of these factors. That pretty much screams out “very serious condition”. A huge percentage of the public has at least one of the conditions and many have more. Some have it not because of what they eat but due to other factors such as diabetes, genetics, other chronic illnesses. There’s the question of what “high” is, since medical science keeps dropping the numbers lower and lower. So more and more people fall into the category. That’s not science, so far as I can tell.
You responded with an hypothesis that lacks much evidence. Many experts debate this “metabolic syndrome”. So yes, you answered, and no, I’m not buying the answer.
Goldrider: I agree to a point. I have heard the blame placed on the Boomers and it may be true. I don’t know. However, I agree that the terror of aging and putting on weight are very bad. There’s a reason you are supposed to slow down with age. You break more easily.

Are you then blaming baby boomers for their joint replacements because they were too active and they deserve to destroy their body for abusing it? Extreme athletes should be outlawed? Where do we draw the line? Is there any consideration of individuals or are we all just an average?

I don’t care what you do to your bodies. Just don’t make me pay for it. That way I won’t be blaming anyone, because I simply won’t care.

Reply to those on this comment thread ==> Here we see the polarization in Nutrition Science — which this essay is about. I write about the War On Sugar — the Sugar Wars — which is a mere subset of the greater, endless, Nutrition Wars — a Very Hot Button Topic.
The essay is not, however, about the relative nutritional merits of sugar consumption — it is about the fact that it is a Modern Scientific Controversy (MSC)– well demonstrated by the discussion on this thread — not only controversial, but like other MSCs, emotional for those involved.
I did warn that the simple facts were simplified. But the public health view and the reality presented are accurate.

To: gringojay July 20, 2016 at 12:26 am
The zone diet has been tested in a hospital setting where all food was accounted for. It worked. It is not a low carb diet as it has 40% of the calories from carbs (30% from fat & 30% from protein). The whole idea is low glycemic load carbs, low fat protein and mono-unsaturated fats for your food sources.
It is all about controlling inflammation and controlling insulin.

Hi TRM, – I have read the ZONE diet early publications & seen some later studies citing it. If you find it ideal for certain reasons fine, I don’t think this sugar thread is suitable for me to make comments about specific diets – others here might wish to say some things regarding ZONE diet if you ask general readership. Since you addressed me I am responding to let you know I have seen your specific comment & am not ignoring what you wrote.

Thanks and I understand your point. I realize the article is about sugar but therein lies part of the diversionary tactic used by a lot of “science”. It isn’t just sugar that has a high glycemic load and low nutrient density. Lots of carbs share those properties. Until the debate is redefined it goes in circles much like the climate change debate.

TRM July 19, 2016 at 9:14 pm
Interestingly the research at Harvard Medical School on GL shows that ordinary table sugar has a lower GL than most grains. Most table sugar is a mix of glucose & fructose so the fructose gets absorbed much slower.
Table sugar is not a ‘mixture of glucose and fructose’ it is sucrose, a disaccharide, which is a chemical compound which when hydrolyzed forms a molecule each of glucose and fructose. In the body that hydrolysis is controlled by enzymes with inhibition by glucose.

Thank you for the correction of my misunderstanding. I found it very funny that table sugar had a lower GL than most grains (oats & barley being the only ones lower). The finer points of the sucrose–>glucose+fructose I obviously missed.
Thanks again. I learn a lot on this site. I like that.

Note re: WebMD ==> Some readers obviously did not look at the linked video hosted by WebMD, which features C. Ronald Kahn, M.D., President and Director of the Joslin Diabetes Center, explaining in simple English the relationship between diabetes and sugar as :
“Eating a lot of sugar definitely does not cause diabetes, if you don’t eat so much sugar that you gain weight. ”
Some degree of distain for WebMD is appropriate, as is a lot like Wikipedia, in that it can be an easy entry level source of information, but great caution is needed — it is a mixed bag of solid medical information and advice sprinkled throughout with utter new age nonsense. One has to check the sources quoted on WebMD — as in this case. Dr. Kahn is a well-respected diabetes expert.
I could have linked to any one of a dozen or more pages from the CDC or NIH — providing the same information — but I like the simple language of this little video.

The obesity problem really went into high gear when the FDA went on it reduce fat and protein kick. They created a food chart that favored of carbohydrates and that change to the food chart in the seventies caused obesity really ramped up. The educated morons failed to recognise that all carbohydrates have to enter the blood stream as sugars and the body can only do two things with sugar once it hit the blood stream, that is burn it or store it and the body needs to store sugar fast and it the sugar is converted to fat and is stored as fat. Fats and proteins do not have that problem. They can reside in the blood stream for a lot longer not causing any problems.

That’s a popular misconception. TV and video games are responsible for all this flab, right? Dunno about your ancestors, but mine were not toiling in the fields behind a plow all day, nor were they chasing down gazelles. The men sat in their office chairs doing something grueling like accounting, and the women sat around the parlor chatting and knitting. They all ate whatever they damn pleased, and a surprising number of them lived to be 95 to 100 in an age when the “official” life expectancy was 49. Got the family tree to prove it!
Furthermore, NEVER has it been said that sitting down studying, reading important books, day-trading, or writing the Great American Novel are “bad for your health!” I guess there’s “sitting,” and there’s SITTING.
Once again, it’s an attempt to regulate people’s behavior via the secular morality of “health,” which allows
the elites to put on their Spandex and go Spinning to virtue-signal. That’s about it. There’s no “there” there. 😉

Goldrider: Yes, I think there is sitting and then there is SITTING. There’s also genetics. I am not in any way discounting that. My ancestors were picking cotton as children and worked in very physical occupations much of their lives. My mother gained weight when she decided to just sit in front of the TV in a tiny apartment rather than keep her house and stay active. My father never gained an ounce. He was active in every job he had from laying bricks to security guard. My grandfather was a bricklayer. So, my ancestors were obviously not doing the same as yours.
There is no need for spandex and spinning—that is indeed showing off. However, there’s walking, gardening, hiking, etc that involve activity. I personally find no reason to go to a gym, jog, etc. There are plenty of ways to burn calories around the house. Going to the gym does keep you from munching on food, though. 🙂

I remember that time – people reduced fat consumption to a level that remained above recommendations and maintained their increase of calorie intake. Average per capita daily calorie intake from meat, eggs and nuts decreased from 512 in 1994 to 506 in 1997, calories from dairy had a very slight reversal in 1996-1997 from their steady increase, and calories from added fats and oils decreased from 453 in 1993 to 426 in 1998. The intake of total calories merely had a slowdown during this time from their steady increase, with a 1-year slight interruption from 1994-1995.
Then the second and greater wave of the low carb fad arrived. Daily calories from flour and cereals decreased in 1999-2000 to 2004 and calories from added sugars and sweeteners decreased from1999 to 2003. Meanwhile, calories from meat, eggs, nuts and dairy increased and largely peaked in 2004, while calories from added fats and oils increased and since then largely did not turn back, and total calorie intake increased to its peak in 2002-2004 (3 of 4 years that exceed 2600 per capita) and only slightly decreased since at levels that continued being excessive.
During and after all of these times, waistlines expanded.http://www.ers.usda.gov/datafiles/Food_Availabily_Per_Capita_Data_System/LossAdjusted_Food_Availability/calories.xls

I have weighed 195 lbs at 6′ for 30 years. I have found a direct correllation to physical activity, metabolism maintenance, and weight/fat, general level of shape for the age.
We dance around the root issue for the most part when it comes to health. The older we get the less active we become in todays world, let alone the younger folks, sedate, pixelated world.
It’s the math eventually.
Just sayin…..

I had a surgeon business colleague a decade ago who swore potato chips were by themselves a well rounded diet. Carbs, protein, fats, and salt. Thats what he ate for lunch every day. Me, tunafish salad and lettuce on whole wheat was the usual carry in order.

Absolutely. My husband is always being asked how he can eat so much and not gain weight. I have a very high metabolism and could eat all day and not gain. Both of us are very active. He eats when he’s hungary, I eat when my insulin says I will eat. I have relatives that gain weight by eating one donut (not really, but you ge the idea). Everyone is different. Some swear by protein, some by carbs, etc. We have forgotten how to eat by the signals our bodies give us and instead eat while watching TV, eat socially, eat for comfort, etc. Food is no longer fuel, it’s a fight, a social event, a temptation, etc. All this “science” just makes things worse.

Exactly, Realty check! Sounds like you have the metabolism of a Thoroughbred. I hand those guys bucketfuls of grain twice a day, and it’s still hard work to keep their ribs covered. On the other hand, the draft horse and pony breeds keep on wizzled-up crab grass alone, and get too fat on it! One handful of grain could put some of them into metabolic shock. WE ARE NOT ALL WIRED THE SAME. Not that the oxymoron known as “public health” can figure that out, of course . . .

Changing disease definitions: Implications on disease prevalence.
Eff Clin Pract , 1999;Vol. 2: 76-85
This paper describes how the so-called metabolic disease risk factors were re-defined in the late 1990’s resulting in a diagnosis of illness of around 50% of the US population – with no clinical symptoms.
Steven Woloshin (the lead author) has continued his work and a later book is reviewed here:https://www.sciencebasedmedicine.org/overdiagnosis/
Take away the definitions of a disease based on “normal” levels of a continuous physiological character (blood pressure, cholesterol etc.) and there is no such thing as metabolic disease and nothing for the anti fat/salt/sugar people to scare you into buying their products.

I used to think the idea of disease mongering was sort of a conspiracy theory idea. Then, going to the bathroom too often, dry eyes and other very questionable things were declared to be diseases. Now, I see the reality of the situation.

Yes I am irritated by the crusade against sugar.
Common table sugar = sucrose = disaccharide of the monosaccharides glucose and fructose.
Glucose and fructose have always been fundamental to human nutrition and make up plant carbohydrate and fruit and honey sugars.

I did not say potatoes have fructose (they only have around 0.2g/100g)
I did say that half of the sucrose (table sugar) molecule is fructose.
And fructose is found in honey, tree and vine fruits, flowers, berries, and most root vegetables.
So it has always been a natural part of the diet of humans and most animals.

If you are saying that plant carbohydrates cannot have fructose molecules, you are wrong.
A fructan is a polymer of fructose molecules.
Fructans occur in foods such as agave, artichokes, asparagus, leeks, garlic, onions (including spring onions), yacón, jícama, and wheat.

Yes. All plants have fructose, just not always a lot of it. On of the big problems in storing potatoes is the fact that at cold temperatures the the fructose accumulates and turns brown when fried (referred to as “cold-temperature sweetening”) and is a big problem in the chip industry.

But not HFCs, invented by the Japenese, along with statins, maybe it’s their revenge! Western diets have moved to a high carb diet through continued bad national guidance re as was said Ancel Keys and sat.fat wars. The parallel between the the establishment stance on global warming, and CVD is obvious. Without the internet and blogs such as this there would hardly be a debate. However type 2 diabetes and obesity has risen with national guidance and use of HFCS. Fructose is processed by the liver only and HFCS has given rise to non alcoholic fatty liver in children. Not sure if that’s natural!
Not a good article.

Type II diabetes and “obesity” have mostly risen because committees from medical advocacy groups, dare I say “trade guilds,” in collusion with pharmaceutical companies, have by fiat been cranking the working definition of “normal” lower and lower, every decade or so. To the extent that sooner or later by their definitions, EVERY ONE OF US will AGE into “diabetes,” “high blood pressure” etc. Nowhere is it usually mentioned that Nature designed these numbers to increase incrementally as we age–maybe for a damn good reason, like preventing the dementia which is now so much more prevalent.
At the end of the day, this is little more than a pharmaceutical quest for immortality, which has been going on since the days of alchemists. The more things change . . . but we can CHOOSE not to participate!

Glucose and fructose have always been fundamental to human nutrition and make up plant carbohydrate and fruit and honey sugars.
Glucose – yes.
Fructose – wrong.
As Lustig points out, every cell in the body can use glucose as is.
And if there’s no glucose eaten, the body creates it ( neoglucogenesis ).
Fructose? No – a very complicated trail of reactions takes place that predispose the creation of fat and fatty liver disease. And the body does not create fructose.
It’s true that there is some amount of fructose in fruits and vegetables. But the things we call fruits and vegetables today are not what we ate through evolution. Before agriculture, our exposure to fructose was not very much and not very frequent. Here’s what fruits and vegetables used to look like in the wild.
Compared to a liter of Coke? No wonder we’re sick.

Turbulent Eddie is making an excellent point that I hope people at least give a thought to. In it’s natural state, before selective breeding to make it larger and sweeter, fruit was available only for a short time during summer and never in the quantities you can get today. Nowadays you can have any fruit you want at any time of year. As a kid I remember not having access to a lot of fruit in the winter because it was out of season, now we get it from around the world and it’s always available.
Fructose kind of flies under the radar for a lot of folks because it doesn’t raise blood sugar and people think that fruit is natural and therefore can’t hurt you. This is probably not the case. A molecule of fructose found in an apple is the exact same molecule found in HFCS or white sugar, no difference.
What I wonder about is that if fructose is okay for us to eat, why does the body metabolize it in the liver where all the other toxins are disposed of? Why didn’t we evolve a pathway whereby fructose is metabolized as easily as protein and fat? I suspect that fructose is viewed as a toxin by your body so I don’t each much of it nowadays.

Reply to Turbulent Eddie ==> Lustig is one of the major voices responsible for the War on Sugar — his views are very radical and way out on the edge. They do not align well with the actual experimental findings. Read the latest journal article giving a whole topic review..
It is extreme polarized advocates like Lustig that cause Modern Scientific Controversies that damage the reputation of science in general and , in this case, prevent the general public from coming to a rational understanding of nutritional issues.

You didn’t even distinguish between fructose and glucose in the posting,
so it doesn’t sound as if you even watched Lustig.How bad is fructose?Fructose differs in several ways from glucose:
Glucose stimulates insulin release from the isolated pancreas, but fructose does not.
Fructose cannot enter most cells, because they lack glut-5, whereas glucose is transported…
…once inside the liver cell, fructose can … provide glycerol, the backbone for triacylglycerol.
In one study, the consumption of high-fructose meals reduced 24-h plasma insulin and leptin concentrations and increased postprandial fasting triacylglycerols in women, but it did not suppress circulating ghrelin, a major appetite-stimulating hormone (4).
Fructose is metabolized, primarily in the liver, by phosphorylation on the 1-position, a process that bypasses the rate-limiting phosphofructokinase step (4). Hepatic metabolism of fructose thus favors lipogenesis, and it is not surprising that several studies have found changes in circulating lipids when subjects eat high-fructose diets (4).
In the study conducted by Aeberli et al (1), dietary factors, especially fructose, were examined in relation to body mass index, waist-to-hip ratio, plasma lipid profile, and LDL particle size in 74 Swiss schoolchildren who were 6–14 y old. In that study, plasma triacylglycerols were higher, HDL-cholesterol concentrations were lower, and lipoprotein (LDL) particle size was smaller in the overweight children than in the normal-weight children. Fatter children had smaller LDL particle size, and, even after control for adiposity, dietary fructose intake was the only dietary factor related to LDL particle size.
In this study, it was the free fructose, and not sucrose, that was related to the effect of LDL particle size. Studies in rodents, dogs, and nonhuman primates eating diets high in fructose or sucrose consistently show hyperlipidemia (4).
The current report by Aeberli et al suggests that the higher intake of fructose by school-age children may have detrimental effects on their future risk of cardiovascular disease by reducing LDL particle size. It is interesting that this study did not find a relation of dietary fructose with triacylglycerols but did find a relation with the more concerning lipid particle, LDL cholesterol. Another recent report has proposed a hypothesis relating fructose intake to the long-known relation between uric acid and heart disease (3). The ADP formed from ATP after phosphorylation of fructose on the 1-position can be further metabolized to uric acid. The metabolism of fructose in the liver drives the production of uric acid, which utilizes nitric oxide, a key modulator of vascular function (3). The studies by Aeberli et al and Nakagawa et al suggest that the relation of fructose to health needs reevaluation.

“Lustig is one of the major voices responsible for the War on Sugar — his views are very radical and way out on the edge. They do not align well with the actual experimental findings. Read the latest journal article giving a whole topic review.”
Replace the name Lustig with Eschenbach. Still excited about how experimental findings don’t align with his “radical views”?
I read the abstract of the study you cited above and it was actually a real nothingburger. They say “There are plausible mechanisms and research evidence that supports the suggestion that consumption of excess sugar promotes the development of cardiovascular disease (CVD) and type 2 diabetes (T2DM) both directly and indirectly” and that there are also studies that may not support this idea. Without going through and looking in detail at each and every study cited in the review (something that would take months or years to do critically) why are you so quick to write off Lustig as a crank? Simply because his views are thought to be “extreme”? Because his views don’t fall into a consensus? Why is it so easy to accept that warmist climate science is awful and that claims of a consensus view can still be nonsense but not believe the same thing may be occurring in nutrition?

Reply to Bob Johnston ==> It is not that Lustig’s views are outside the consensus — it is that he is one of the Great Exaggerators of the War on Sugar. He is not content with the actual facts about sugar — he stretches the clinical and research evidence to the point of breaking and beyond — naming sugar a “poison” and popularizing this view through YouTubes, speeches, and popular nutrition advice books. He is a campaigner — which is his right, of course. That he inflates evidence, deflates counter-evidence, name-calls, pushes conspiracy theories (Big Sugar) — all the behaviors that give Nutritional Science a bad name — is why I label him an “extreme polarized advocate…. that cause[s] Modern Scientific Controversies that damage the reputation of science in general and , in this case, prevent the general public from coming to a rational understanding of nutritional issues.”

It is not that Lustig’s views are outside the consensus — it is that he is one of the Great Exaggerators of the War on Sugar.
Kip, this is not what you said. Your words were Lustig is one of the major voices responsible for the War on Sugar — his views are very radical and way out on the edge. They do not align well with the actual experimental findings. Read the latest journal article giving a whole topic review., you’re literally saying that his words are not backed up by research and then you reference a review that says his point of view is “plausible”. What am I missing?
I think you’ve made up your mind and have no interest in changing it, regardless of what the data may or may not say.

There is much written about this topic and carbohydrates generally. I have read some interesting research papers.
I am no doctor but I have seen some excellent presentations that show the metabolic processes around food and a number of things strike me as important. Excess sugar suppresses leptin, the hormone that suppresses hunger. Second, reducing sugar and carbohydrates intake does lead to a weight loss ( depending on how much you shovel into your pie hole) and a reduction of many of the nasties like insulin resistance, high BP, blood lipids and cholesterols. I have many friends who have had remarkable turnarounds from weight problems, elevated BP and diabetes by simply reducing the sugar/carb intake a lot. I am not interested in a debate because everyone needs to choose their own medical adviser and everyone is different. I just thought it was interesting that reducing a “non essential?” food intake could result in better health outcomes for so many people I know personally. I lost 15kg’s easily by just cutting out the crap. BTW, fat is fine and tastes great. The low fat foods are full of extra sugar, so I avoid them. I also avoid McFrankenstein and the other sugar loaded take aways. For what it’s worth.

Wow, what a load to the third power of BS. The above mess that is discussed confuses several different effects.
If you eat too much fat (lipids), you store fat. If you eat too much sugar or carbohydrates, you make and store fat. If you eat too much protein, you convert half of the amino acids to carbon skeletons, make sugar and then fat. We are designed to take excess food and store the excess as fat.
Now, regarding diet, we were never meant to have high levels of glucose in our diet. Carbohydrates were a small part of our diet that was normally only available in late summer and early fall until the advent of agriculture, which made the excess productivity allow carbohydrates to be available year-round.
Until then, we were more like bears. We lived on animals until Fall when we would pork up on sweet berries and fruits, storing the excess calories as fat. We are designed to convert excess calories to fat, just like bears.
This propensity to convert excess calories to fat, even at the time scale of each meal, is what makes the current 50-year American diet such a burden. We are constantly telling our bodies to make fat, literally with every meal.
The same carbohydrate heavy American diet also introduces high concentrations of glucose into the blood stream after every meal. This high concentration causes osmotic problems in the lining of our arteries, causes the surface cell layers to swell and allow lipoproteins from the circulation to move to behind the surface cells, which then irritates the cells in the area—this is the definition of atherosclerosis.
Why are the lipoproteins able to enter into the small holes in the luminal cells of these arteries? It is because the low cholesterol diet that Americans have been taught to ingest makes for small lipoproteins bodies to be produces by our livers. These small lipoproteins can enter into the small holes created by the glucose-induced swelling of the arterial lining.
This is a two-way attack on our arteries. If you ate a normal or high cholesterol diet, your lipoproteins would be larger and not able to invade and irritate the lining of the arteries. And, if you ate a low carbohydrate diet, there would not be holes through which small lipoproteins could pass.
It has been shown that males with high cholesterol levels live the longest. As human males are the weakest half of the species biochemically, it makes sense that cholesterol is actually a beneficial chemical and not the demonized nutrient that we have been worrying about. Cholesterol, in one of its several positive roles, makes for large lipoproteins that do not hurt us but do their job delivering their contents.
Think about it. Historically, primitive humans mainly ate meat and fat, eating carbohydrates only during the late Summer and Fall while bulking up for Winter, just like bears. We have not evolved much since then.
We should be eating mostly animal protein (complete protein) and animal fat. That’s actually all we need, with the addition of a few fruits for vitamins C and K and maybe E. Where in here are the carbohydrates? Only for gaining weight.
People love their starches, but if they are stretched their carbohydrate intake out into small doses, the arteries will not see the damaging glucose concentrations. Balanced with healthy or even high cholesterol intake, the arteries will be healthy and unimpaired. Two eggs a day is an absolutely normal, if not low cholesterol intake.
A nod to the Mediterranean diet. When this diet was first described by the main originator of the American diet high in carbohydrate, Anzel Keyes, he described an island who population that had a very healthy population with very low heart disease and they were mainly eating grains and vegetables. However, the investigator neglected to note that this was right after the 2nd world war and the Nazis had stolen all of their livestock. As soon as they could replace their livestock, the residents of the island went back to a high meat and animal fat diet. There is no such thing as a Mediterranean diet.

Higley7 you are on Watts Up With That using reasoning that would make any Global Warming Alarmist proud. On the fire department that I worked on for 25 years the “Atkins Diet” was king as soon as it became a fad. So I heard what you are spouting over 15 years ago and high protein diets are still the rage. It has now been long enough for those who are old enough and observant to gauge the effect of this ongoing fad on our long time friends and acquaintances.
The sad truth is that I don’t know even one person who went on a high protein diet who kept the weight off long term and I know many who had severe health issues after they swallowed your line of reasoning and stopped eating a balanced diet. Some actually became so unhealthy they had to retire and a couple actually are now dead.
Most went from overweight to obese and yet they persist in the madness, because they love any excuse to eat massive quantities of delicious fatty meats. The person who was my driver on the ladder truck I was in charge of went from 300 to 450 pounds and was forced to go to fire communications where he continues to gain weight to this day. He is great guy and very intelligent. He still says word for word what you do about how are bodies are more suited to eat meat and why. Does observational data mean anything to you?

If you eat too much fat (lipids), you store fat. If you eat too much sugar or carbohydrates, you make and store fat. If you eat too much protein, you convert half of the amino acids to carbon skeletons, make sugar and then fat.
It’s not so simple.
First, we should decide what we’re concerned about here.
People are concerned about fat, but what kind?
Subcutaneous fat looks horrible in a speedo, but is evidently not that bad for you.
Visceral fat is metabolically different and more harmful.
Fat in our muscle cells, and even worse, our organ cells, is not visible but deadliest of all,
because they’re implicated in diabetes, which is probably more important than fat.
Also, is the NET of calories taken up versus expended that matters, not what you eat.
If you ate 110% of your required calories in fiber, you might actually lose weight because you wouldn’t actually take up the full calorie load, plus the fact that it takes energy to break down the fiber.
If you ate 110% of your required calories in Coke, you would gain weight because glucose and fructose are taken up so quickly, not much is lost, and glucose needs almost zero digestion.
Fats and proteins are similarly endothermic, requiring the use of calories to digest ( exercise in a meal ).
And, while exercise can be healthy, it turns out that by far most of the calories we burn are from resting rate.
And so does eating less over a long term!http://www.eattoperform.com/wp-content/uploads/2015/04/neat_graph.pngWe are designed to take excess food and store the excess as fat.
Yes!
And this is key – the reason we’re designed to store fat is because
we evolved to go without food for extended periods of time.
When they cut up Ootzie the ice man, they found goat and deer.
And while he ate well before his death, it seems likely there were days, perhaps many days, when he wouldn’t kill anything for dinner. ( maybe he ate some grass or leaves or something ).
So, if we want to go paleo, meat and veggies are OK.
But what we also need to eat more of is… nothing.
Fast one day a week.

Reply to Krischel ==> Because this essay is about the WAR not the details. If you want to read about sugar metabolism there are entire libraries of science on it — and in the War on Sugar — there are lots and lots of opinions and booksellers get rich on the proceeds of books on the latest fad ideas.
Pick the one you like and fight fight fight for the right!

What about ‘economic interest’ in unhealthy systems and the role of research?
Excess food production US:
US daily calorie intake per capita*: 3770
Needed daily intake** 2200
Excess calories (3770 – 2200) 1570
Excess food production 1570 : (1% of 2200) = 71,36%
Conclusion: there is a strong incentive to keep production on the same or higher level even if ‘health’ requires a lower level.
Opinion: This will influence ‘research’, especially when universities and other institutes for their research [partly] are dependent on business funding.
* http://www.dailymail.co.uk/femail/article-2722815/Daily-calorie-intake-countries-world-revealed-surprise-U-S-tops-list-3-770.html
** men 2400 calories daily, women 2000 calories

Tim Hammond, the above numbers are about calorie INTAKE of US citizens. It is not about national production.
Besides that, when you look at the graph in the link above you will see that the US is not alone in ‘consuming more than 2200 calories a day’. Just some countries are mentioned.

“Obesity Paradox” is not holding up as valid. Analysis of just under 4 million never smoking non-chronic diseased individuals ( when 1st entered studies) who then did not die within 5 years were tracked for ~14 years has been culled from 239 studies. Just under 2 million subjects in those studies were excluded from cross-referencing in attempt to keep confounding cases from the analysis.
The analysis did not attempt to parse causation. Of those 3,951,455 people 385,879 passed away & the survivorship sweet spot was 20-25 BMI. The data indicated that if merely overweight (not obese) there was just a statistical 7% greater association with mortality; I am aware of limitations to BMI & accept it’s use to correlate across so many different studies. (2016, July issue) journal Lancet, “Global BMI Mortality Collaboration.Body-mass index and all-cause mortality: individual participant data meta-analysis of 239 prospective studies in four continents”.

Meta analysis? At best meta analysis brings in all the problems of simple analysis like publication bias and poor methodology, and at worst it adds a layer of new problems, like selection bias and trawling for significance
We know that at least 70% of published research is flawed, faked or just wrong. A meta-analysis can easily pick just the studies that suit the researchers, and thus all the studies inlcuded could be falwed, faked or wrong.

Hi T.Hammond, – The cited report tried to at least get rid of a good proportion of the confounders & then report the statistical trend for those that seemed to be worth considering. There were actually ~ 10,600,000 individuals in all those studies they tried to sort through in an attempt to resolve, as best possible, the kind of issues you bring up here.
The BMI was used as a correlation to “premature” risk of dying in the approximate 40% of the original subjects that made it through the best filter the raw data supposedly had. By the way, outside the sweet spot BMI the increase of ~7% premature mortality risk (for lack of a better brief term) was for 25-27.5 BMI, went next to~ 20% “risk” until 30 BMI, then up to ~45% greater risk until 35 BMI & so on upward non-linear with greater obesity.
Allow me to repeat my understanding that BMI is not an absolutely perfect metric & add that I am aware genetics vary. Furthermore, the terminology of “premature risk of death” is not easy to work with on a personal basis; dying a few days/weeks/months than statistically probable is hard to place a value on (at least by me).
If you wish to say the “obesity paradox” has not been seriously challenged by the cited study then it seems to me you have some reasons which uphold the obesity paradox theory (no matter what I have tried to summarize) , or have determined where/how this study is definatively flawed in more specific terms than it used BMI data from many protocols. The report qualifies that the “risk” factor is least applicable for women, followed by men & greatest when the BMI of the young is followed (where long term tracking data was available); with cardiovascular disease being the commonest factor showing relevance & then respiratory disease (note: this is not saying obesity is the cause of those diseases).

Hi Kip H.,- study title is that last long quotation marked run on sentence found at end of my original comment above; just out last week 13 July 2016 in journal Lancet. Sorry to admit I haven’t learned to make a blue lettered link on my tablet; it already seems to have gotten some notice on-line & a few of the charts show up.

Reply to GringoJay ==> The link to the study is here: with a follow-on link available there to the whole paper in .pdf offered free.
Note that the study was specifically undertaken to try to disprove the Obesity Paradox — beginning with the initial design.
Even given that, the bottom line of this meta-study is that effect size for BMI 25-27.5 (overweight) is 1.07 — vanishingly small — read clearly here — not clinically significant in any way, given at a level of precision that is absolutely impossible to validate in a meta-analysis.

Again Kip H., – the theory name is not “overweight paradox” & you can see cited study for 30 BMI the “risk” is not like the 27.5 BMI (which I too pointed out is minor). While on subject want to give my understanding of why (beyond genetics) many obese are definitely not prematurely dying. Unfortunately my memory of exact data & publication title is deficient.
A modern geriatric northern european (Denmark?) population that was still living in their communities (not nursing home) who were overweight & obese led research team to conclude why
being obese did not automatically lead to premature death (after adjusting for confounding health issues) & in some played out better than “ideal” BMI individuals . The insight was that since obesity increased intestine permiability to lipopolysaccharide (LPS, lipid+polysaccharide) from bacteria membranes the constant challenge (antigen) to the obese persons’ immune system kept the immne system working.
It might be described as being an apparent dis-function (permiable gut) being also a functional impetus to “use it” (immunological function) instead if “lose it” (ability to sustain immunological activity); & longevity is associated more with exceptional immune systems than any specific diet composition. As you’d expect this did not play out as well for the morbid obese (very high BMI).

Kip, I would love to see a comprehensive analysis of the science behind Ozone hole theory, with real historical context.
Ever since “discovered” in the discarded data of the Toms satellite, the instant unprecendentness has bothered me.

“The policy proposals that the general public must be somehow forced to reduce their intake of sugars, through FDA [(in the US) Food and Drug Administration} nutritional advice, pressure on the food industry to reduce added sugars, through outright propaganda aimed at the public, and through attacks-by-regulation (so-called soda taxes) on the sugared-drinks industry are all based on the premise that if the public consumed less sugar they would be less fat and more healthy …”.
===========================
Governments should first of all be reducing deficits by reducing expenditure — that’s obvious.
But given that taxation is inevitable it is preferable to tax expenditure rather than income e.g. ’sin taxes’, i.e. taxation of discretionary spending on products which may be harmful in excess as long as that tax is not just a spineless substitute for prohibition.
J S Mill (On Liberty chapter V): “… These considerations may seem at first sight to condemn the selection of stimulants as special subjects of taxation for purposes of revenue. But it must be remembered that taxation for fiscal purposes is absolutely inevitable; that in most countries it is necessary that a considerable part of that taxation should be indirect; that the State, therefore, cannot help imposing penalties, which to some persons may be prohibitory, on the use of some articles of consumption. It is hence the duty of the State to consider, in the imposition of taxes, what commodities the consumers can best spare; and à fortiori, to select in preference those of which it deems the use, beyond a very moderate quantity, to be positively injurious. Taxation, therefore, of stimulants, up to the point which produces the largest amount of revenue (supposing that the State needs all the revenue which it yields) is not only admissible, but to be approved of …”.
Mill also approves government guidance, warnings, badgering etc. but not prohibition (which doesn’t work anyway).
In the case of cigarettes booze or general nutrition advice that especially applies in countries where individual health is largely insured by taxpayers.

I do not know what country you live in, so I will comment for the US.
” given that taxation is inevitable”
True. Taxes must be levied to pay for essential services which cannot be otherwise financed, such as an adequate defense.
“taxation should be indirect”
No. Taxes should be visible and as direct as possible. Nothing is hidden, especially not agendas, which are too easily hidden when the taxes are hidden.
“the duty of the State to consider, in the imposition of taxes, what commodities the consumers can best spare”
Doubly wrong. Taxes must be as broad based as possible. All people benefit from essential services (such as a strong defense), all should contribute and understand that everything costs money. Second, Govt. has no business deciding for us what is “positively injurious”, and even less business enforcing these opinions on the people. Using the full force and coercive power of the state through taxation to enforce social policy is the absolute death of individual liberty.

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.

In the US, there are a lot of things that the Govt. simply has no right to do. This way of doing things had never been tried before, that’s why it was so revolutionary.

There is a GREAT deal of epidemiologic evidence pointing against this sugar war.
Also, against the fat war.
And, against the “obesity” war.
And at the alcohol war.
Across the globe, these dietary components are not the evil they are made out to be. They simply do not show up as predictors of mortality, and do not show up strongly as predictors of morbidity.
What does show up: inactivity.
Mostly inactivity.
Here is another hidden gem: make a list of the things that lead to constipation/slow-few bowel movements. Cheese/dairy, meat, incl red meat. Too little water, too little dietary fiber.
And another list: the things that lead to “regularity.” Plenty of water. Exercise, fruits and vegetables/fiber. Low meat, low dairy.
Now look at the associates of cancer.
Might cancer be a problem of too-slow or too few bowel movements?
I reviewed a paper once. They dismissed “regularity” as a cancer risk. I pulled up their 3 citations. Lousy/no defense of this claim. They dropped their statement that regularity was dismissed as a cancer risk. –they suffered from common knowledge. I look back at that paper every now and then. It has been cited a lot.
I thwarted the myth that there is no relation between regularity and avoiding cancer.
Outside of the “developed” world, especially in older investigations, being “overweight” imbues no, or little, increased risk for early mortality. Why not? Outside of the “developed” world, the poor/lower income are regularly physically active. Sweep, chop, walk, fold, carry, slice, pound…….put a pedometer and see if they are reaching their 10,000 steps per day. Yup. Now, what about our poor here in the developed world?
A great cause of our morbidity and mortality is wealth: we are so wealthy – so efficient and powerful at delivering tasty calories to the entire population, rich and poor, that the poor do not have to work so physically, and can enjoy diets of excessive pleasure once reserved for nobility. And, while many “poor” work at physically hard jobs, a lot do not; we are so wealthy that we can support them and they do not have to labor so hard.
If our health problem is wealth, then can it also, simultaneously, be poverty?

Was almost hoping this would end with a sarctag, Kip. Going into health discussions, quoting the obesity paradox. You dont need to be into medicine or dietary science to know that this so called “paradox” is more flawed than climate models.
Not only does people lose weight when theyre dying due to terminal illness, but “athletic” people, myself included are considered “overweight” by BMIs defintion.
This is not a scientific documentary, but theres one out called “The Sugar Film” about an healthy australian who adds 40 tsps of sugar to his diet in the form of smoothies/juices, stuff touted as healthy. And you can see how fast his body deteriorates.

Not sure any of your comment makes sense. A film? That’s your evidence? And dying people lose weight, so being “overweight” isn’t healthy? What?
The biggest and simplest studies show that people with BMIs that are classified as “overweight” live longer and are healthier longer. Sure, that research may be shown to be faulty, but not by a silly film.

The movie was not evidence for the obesity paradox being faulty, your own critical mind would be more than enough evidence that it’s faulty. Im not sure how my post was so hard to understand.
People with terminal diseases generally lose weight = More sick people with average-low BMI
People who work out, gain musclemass and less fat volume = Athetlic people have an BMI that put them in the overweight category.
“We know that at least 70% of published research is flawed, faked or just wrong. A meta-analysis can easily pick just the studies that suit the researchers, and thus all the studies inlcuded could be falwed, faked or wrong.”
I figured anything anyone posts as “evidence” in response to you has no chance of passing your scrutiny unscathed. Meaning you’ve made up your mind already.

Reply to wolfho ==> You seem to be under the impression that I am arguing something or other — I am not. I have clearly stated that I have no stake in the War on Sugar. This essay is about The War — not the participants or the details of the individual battles. It is one in a series of essays about Modern Scientific Controversies — Science Wars — persistent scientific contention.
The Fructose Battles and the Insulin Spikes battles are sub-sets of the War on Sugar — and your are right — very dear to the hearts of many of the combatants.
If I were writing a BOOK on the War on Sugar, I would dedicate a chapter to each of those topics, and discuss the sub-controversy involved with each.
As you may have already guessed, fructose is a post-hoc enemy in the War on Sugar — having failed to find smoking gun evidence that sugar is k-i-l-l-i-n-g us all, the anti-sugar forces have shifted slightly to the left and are trying again with fructose — hinking and dodging to avoid indicting “natural fructose” while vilifying refined fructose or HFCS.
Opinions vary wildly (and emotionally) on this subject — which is one of the symptoms of Modern Scientific Controversies. .
i have explained far above somewhere why the intricacies of insulin function in human physiology are beyond both the scope of this essay (which is about the War) and the educational level of the readers.
[ The reason you got push back on the movie is that it is simply a propaganda film, in all probability faked, and nothing in it can be accepted at face value. Such films poison the entire field of Nutritional Science by obviously exaggerating potential harms, violating the trust of the viewers to the point where they tend to reject the entire field of study. ]

Reply to wolfho ==> The film you refer to is “That Sugar Film” . It is a blatant piece of propaganda and is, I strongly suspect, as cocked-up as its predecessor “SuperSize Me”, which has been subsequently discredited.
Generally, propaganda “fake-umentaries” are not good sources of scientific information.

Why does everyone keep focusing on the movie, I never said it was scientific? It gives a basic jist of the different sugars, insulins function and the bodys response. It isnt a predecessor any more than any Space documentary is a predecessor to the first space documentary.
Why dont you mention fructose or insulin in your OP, Kip?
Why do you use arguments such as Obesity Paradox?

My understanding is that the ‘fat makes you fat’ meme is completely wrong. Excessive sugar consumption makes you fat. Reason is that the digestive system can only process fat slowly, whereas sugar needs virtually no processing, and therefore hits the bloodstream very quickly. If that surge of fuel cannot be used immediately, then it has to be stored as fat.
As a hillwalker I’ve learned not to eat sugary snacks in mid journey. What that does, is to give you a rush of energy lasting an hour or so, after which you ‘crash out’ and find it hard to continue. Eating a mix of carbs and fats keeps you going for the rest of the day.

Insulin does not respond to fat, protein to some extent. Insulin makes you fat. Fructose is processed by the liver it’s bad stuff. Table sugar is 45 per cent fructose. The body has no problem with sucrose.

I agree. The work of Canadian physician, Dr. Jason Fung shows that fatty liver due to excessive fructose consumption (fructose goes straight to the liver for metabolism) is the root of metabolic disease. He has excellent success reversing this condition by removing most carbs (especially sugar) and fasting. Give the poor body a break from constant insulin exposure!

I have a chemosensor to detect a certain food.
My species has a second name that’s much misunderstood.
Nature tells me to provide a certain monosaccharide-
The only thing a brain can eat is why we like our sugar sweet.

Kip. You’re right about the controversy and many of the issues. But you’ve got a basic problem here in conflating all sugars as being more or less equal. In point of fact the human body can only utilize a small number of the many sugar variants that occur in nature. Primarily Glucose, Fructose, Lactose and some dissacharide combinations of those — Sucrose, Maltose, Galactose.
Not all natural sugars are completely harmless. For example, many non-European adults have limited tolerance for Lactose and have to avoid it or limit intake.
There is not a whole lot of metabolic issue with Glucose and its digestible polymer — starch. Glucose is, as you say, essential to human life. The problem, if there is one, is Fructose. Fructose is converted to Glucose via a rather complex metabolic path that includes generation of a substantial amount of a fatty acid — Palmitic Acid. Palmitic Acid may in fact not be good for one when its constantly present in substantial amounts. At least there is evidence of physiological changes in mammals from high Fructose diets. An apple a day may be fine. Six apples a day, every day, may not be a super idea.
Two possible problems that MAY have some legitimacy. Table sugar is sucrose which is a disaccharide combination of Glucose and Fructose. It may in fact be less good for one than an equivalent amount of calories from starch. Also, Fructose is sweeter than Sucrose which in turn is sweeter than Glucose. People like sweet, so there is some tendency to spike processed food with Fructose to enhance taste. Maybe that’s overdone.
My perception is that much of the controversy over sugar is caused by two things. First, a lack of specificity about what is meant by “sugar”. Yes Glucose — a sugar — is essential to life. But table sugar is only half Glucose. The other half is Fructose which may be a bit iffy. The second problem is a vast numbers of people equate “natural” to “good” notwithstanding that the nearest garden, patch of woods or meadow probably contains several natural plants that can kill them or make them very sick if consumed. That leads to a lot of Honey(natural) is good whereas High Fructose Corn Syrup (unnatural) which is quite similar sugar wise is evil and depraved.

Don K,
Thanks for pointing out that the article fails to enumerate the various kinds of sugars, and in particular fructose.
Dr Lustig (the anti-sugar man) claims that the liver metabolises fructose in the same way that it metabolises alcohol, and that fructose stimulates our appetite much more than the equivalent amount of other sugars.

Well that is an original suggestion — but totally wrong, of course. The liver uses some short, simple adapter pathway to break down fructose to glyceraldehyde-3-phosphate and dihydroxyacetone phosphate, two metabolites that also occur early on in glucose degradation. From then on, the degradation pathways of both sugars are identical.

Absolutely, all sugars are not equal, even when they might appear to be!
The sugar our cells prefer is glucose, which can be taken in as the sugar molecule itself, produced from starch, glycogen, other carbohydrates, proteins, fats etc. We need the requisite enzymes to be able to do this (e.g. sucrase to breakdown sucrose into glucose and fructose), sometimes we don’t have them. The ability of adult humans to process lactose is a recent adaptation primarily among europeans, the absence of lactase leading to ‘lactose intolerance’.
Insulin is one of the hormones used to control the levels of blood glucose, which is stimulated by excess glucose, the other is glucogon, which is stimulated by lack of glucose, the system maintains a homeostatic balance (when working properly).
In the US sucrose has been largely replaced by High Fructose Corn Syrup which is a mix of glucose and fructose, which you’ll sometimes see described as being ‘the same as’ sucrose, but it’s not. Sucrose is broken down into glucose and fructose, which takes time so you won’t get a sudden surge of fructose like you can with HFCS. Such high surges can cause liver problems by overtaxing the enzyme system there.
I have taught an undergraduate lab where the students tested the processing of different ‘sweeteners’ by yeast, measuring the response to monosaccharides (e.g. glucose, fructose etc.), disaccharides (e.g. sucrose, maltose, lactose etc.), natural products (e.g. honey) and artificial sweeteners, the variation in response is dramatic.

The reason for the replacement of cane sugar by corn syrup is the imposition of federal tariffs on imported sugar. The main beneficiary of which is ADM (similarly benefits from corn ethanol subsidies), thanks to Bob Dole!

Reply to Don K ==> Yes, the proper handling of this issue — The War on Sugar — is book length. If I had included even a tenth of the really important points, this essay would be far too long to read.
But here we see that there is a similarity to the War on Sugar with the Salt Wars and the GBR Wars….how the science is communicated to the public resulting in a general rejection of the solutions provided by Science.
There is absolutely nothing wrong with the sensible “basic truth” version of the public health message — if you are dangerously overweight, cut down on calories, added sugars would be a good place to start (along with exercise more).
The rabid exaggerations about the harmful effects of sugar themselves are harmful — people won’t listen because they’ve heard it all before — about fats, about butter, about bacon, about other “one substance” solutions that had to be retracted — Nutrition Science has poisoned itself.

Nutrition science has poisoned itself, and our entire culture, by making longevity out to be some kind of a *contest* and peddling the myth that it’s mostly under our control. In point of fact, over 75% of the metrics of morbidity and mortality can be chalked up to genetic and socioeconomic factors. That leaves just 25% for us to fiddle with via “lifestyle,” and probably 20% of that can be accounted for by NOT SMOKING.
As of now, we have no reliable way to make fat people permanently thin. We have no evidence of there being any health advantage in trying. It is known that yo-yo dieters pay a terrible price. I believe 99% of all this horseshit that’s published on any given day is just to keep us worried about mortality in the interest of SELLING us something we don’t need–including the very idea that we’re in control of our “health” outcome.

Reply to Goldrider ==> Exactly, as we shall see in the yet-to-be-written essay on the Obesity Wars. If you read closely, you will find that the final study linked in the main essay, after all the years of directed research, finds only “strong support for a direct causal/contributory role of sugar in the epidemics of metabolic disease, and for an indirect causal/contributory role mediated by sugar consumption promoting body weight and fat gain”.
The evidence can’t even positively indict sugar for weight gain.

Kip whenever you get around to the Obesity Wars, don’t overlook the mind boggling redefinition of obesity in 1998 that made millions of normal weight range Americans overweight and millions of overweight Americans obese — literally overnight. That was followed not many years later by a declaration of a national obesity epidemic. You’d think the clowns that perpetrated that travesty would be laughed out of town. But no. They’ve been taken seriously.

My 2 cents. If you want to live long, go and talk to the 70, 80, and 90 year olds. I do, it’s part of my job. At this age, they almost never smoke. They drink very little alcohol. They are overweight by modern standards, though not obese. They eat some fats, they eat some sugar, they eat some vegis and meat. Can’t remember when I last met a vegan in this age group. They have a balanced diet in other words, that includes sugar, biscuits, cake, candy.
There is one stand out fact that separates them from everyone else (the ones who didn’t survive). They are active. They are busy. They talk in hushed tones about the friend/neighbour/relative who sat down and rested because they retired.
I listened. I now work part time. I am active when off work. I often walk to work. And my weight stabilised. The reason I eat a little less is that I am busier than I used to be. I take my patients through a discussion on how to get the most out of life. The ones who listen or the ones who know already – live. The ones who follow diet fads (you know – organic/paleo/vegitarian/no sugar/ Atkins/no fat) feel great, but die young.

Where I live we have one vegan, now in her eighties, who swears with a nearly religious tone that her continued health is due entirely due to becoming vegan (she “converted” in her 60’s I think). She swears she is in the best shape of her life and continuously writes letters, etc., pushing the vegan lifestyle. I’m sure such individuals are few and far between, but they are out there.
She does run marathons in her age group, so she is active. How much the activity and new focus in her life (as in preaching the vegan way) contributed to her newfound health and happiness are not known.

An article in The Guardian back in April, described how reduction of fats became the target for health advice, while concerns over sugar were ignored.https://diggingintheclay.wordpress.com/2016/04/11/the-error-of-our-ways/
I’ve never worried about fats, but am of the opinion that sugars and refined carbohydrates are a luxury from a biochemical point of view. If you think about our recent history vs evolution as a species, we have evolved to be able to cope with gluts of honey, fruit or starchy materials, but eaten on a daily basis, all year, no. It is no surprise that studies now suggest major changes in gut microflora that have health consequences, as well as direct effects on human metabolism.
The food excesses we have in our culture have given us huge freedom of choice and quantity, but as the saying goes, with freedom comes responsibility. Sadly so many in our society seem unable to accept that they have to make responsible choices, while others are only too glad to try to dictate and control the choices of others.

The unthinking also imply that “processed” means it is evil and that sucrose is “highly processed” making it very evil. They claim that raw sugar is somehow healthier than the purified product. These folk have obviously never worked in a sugar mill. I’d prefer my sucrose 99.97% pure from the refinery, rather than having it looking brown and “natural” because of the dirt and other muck in it.

Sugar, salt and flavour enhancers stimulate eating. When we like the taste of the food or the drink, we like to have more. We keep on eating, even without any real hungry feeling.
Products without those ‘eating stimulators’ make it (much) easier to keep the wanted weight.
(I myself I prefer a mix of all kinds of food, but I know where I must search for the ‘brakes’ in my food pattern, when necessary)

Reply to Wim Röst ==> Only self-flagelating misguided health-food-faddists eat food that they think tastes bad — food they don’t like. At least here in affluent America, we have so many food choices, from so many world cultures, that one would have to make a determined effort to avoid foods that one found pleasing, regardless of their particular eccentricities about diet.

Excess sugar makes my kids angry & argumentative and less likely to pay attention. I know this to be fact, I’ve tested this hypothesis. I’ve seen it first hand, which is why we have a sweet day once a week, also for teeth too, brushing wont stop excess sugar rot

oh and some Fridays I do eat some junk, treat day 😀 and I have often had a hangover sat morning, from sweets!
Some studies suggest sugar causes the walls of arteries to become inflamed, because the sugar causes abrasion

sugar causes arterial abrasion? that, as you have stated it, makes no freakin sense at all.
nonsensical statements such as that automatically require rejection of all the rest.
just thought you might like to know. only a friend would tell you when you’re so far out.
anybody else might encourage you to go deeper till you can’t get back.
let’s see how this plays out. maybe you’ll be triggered to the deep end. maybe you’ll head for shore.

Another aspect is that weight gain across society is that many people now have two working adults, leading to families eating ‘ready meals’. which when you analyse food labels show high amounts of sugar.
Quite innocuous looking food items can be packed with added ingredients that you would never think of adding if you prepared a similar meal at home.

This is a bit of an oversimplification in part and actually misleading in other parts. There are a couple of significant issues here. One is the vast amount of sugar in our diets even in things that might be promoted as healthy such as fruit juice. The other is the type of sugar. There is emerging evidence that humans do not metabolize huge quantities of fructose well at all and this in particular is harmful. It is highly likely that not all calories are the same.
It is entirely reasonable as a public health initiative to try to educate people as to the large amounts of sugar in everyday food stuffs. (Think of shoveling 1 kg of sugar into your mouth over a month each and every month if you have only 1 glass of fruit juice per day in an otherwise sugarless diet!) It is also entirely reasonable to educate people that not all sugar is the same. There is no sugar war here- just a recognition that a high sugar is probably harmful- probably more so than high fat or salt. What is interesting is that low fat health foods were typically high in sugar and the perhaps misplaced fat and salt reduction obsession has distracted from the benefits of less sugar until now.

Reply to Sam ==> Of course, this is a simplification — but remember, it is about the War on Sugar, not about the science of sugar consumption.
I will repeat here the bottom line, basic truth:
“The basic truth is that people who are concerned about unwanted weight gain, are dangerously overweight or have problems related to the bodies sugar-processing functions, should rather obviously consider reducing the overall calorie intake – with sugars, particularly added sugars, being the easiest calories to identify and reduce.”

Where did you get this nonsense from?
Your intestines are “flushed” with more than 8 liters (2 gallons) of various secreted fluids per day. Compared to that, the amount you might drink with your meals is a drop in the bucket. Also, protein per se is not hard to digest, particularly when properly cooked.

No and stop debating like a troll.
If you drink loads of water with dinner you will be hungry sooner than without. I’ve tested this hypothesis on my own body. It holds true and after 20+ years of not drinking loads of water with a meal, I am 15lbs heavier than when I was 20 years old, I dont exercise really and sit at computers alot, IT is my work.
My wife always drank a lot of water with meals, and her weight was all over the place, no longer, she also eats less now that she doesn’t guzzle water with meals.
I can only speak from experience, and offer advice so I dont get your pretty pathetic attitude.

Funny thing: my father lived till he was 91, had three spoonfuls of sugar in his tea and half a dozen or more cups of tea throughout the day. Me? If I was to consume 18 spoonfuls of sugar in one day I would become seriously ill. Individuals have different tolerances to different substances.
It’s a bit like smoking. Smoking causes cancer….in some people.
The important thing is to educate those people who are intolerant to sugar to recognise the signs so that they can save themselves. Blanket declarations and regulations are worthless.

Sugar cane juice (real sugar) is OK. The evaporated version concentrated sugar powder is poison just like powdered salt. All foods have enough sugar/salt per se. BTW just try drinking a cup of sugar cane juice.

Care to explain what difference the crystal size of salt has to do with toxicity? Crystals of sodium chloride, whether large of small (powdered) dissociate into sodium and chloride ions when placed in water. I completely miss your point.

I heard a theory somewhere (yeah, I know, [citation needed]) that in the Palaeolithic diet, humans would benefit from stuffing all of the fruit they could in Autumn, when it was ripe, to benefit from the vitamin boost and to fatten up for Winter. The fruit was only available when it was ripe, so the whole process was inherently self-limiting. Thus we evolved to over-eat on sweet fruit as a survival mechanism.
Now, the abundance of sweet foods pushes the button on this “don’t get full, stuff! stuff!” reflex all of the time, without the restriction of seasonality. So we get fat.

Big problem with the essay and most of the comments.
All sugars are not created equal. As noted in several places, the body takes carbs and converts some into sugars. The big one is sucrose, table sugar. The body splits it into its two components, glucose and fructose. But it stops when it has what it needs and splits it no more.
Also as noted by some, when the war on fat was declared, the substitute was high fructose corn syrup which is a combination of glucose and fructose. The body just cannot handle an overdose of glucose and fructose and fat results. There is no limiting as with sucrose.
BTW, I am a beekeeper and have loads of honey but consume little as it is mostly glucose-fructose and a bunch of other sugars. For our ancestors, pure sugars were few and we got most of them through our body’s regulatory system by splitting carbs. Our diet bypasses the splitting.
So we are eating the wrong sugars in great quantities all because of the “War on Fat” which has recently been proved to be a phony war. (The low fat diet (20%) has been shown to be unhealthy.)

The activity of the enzyme is usually controlled by inhibition by the product. For example lactose will only be broken down if there is insufficient glucose present, the presence of glucose inhibits the process. See ‘lac operon’.
As pointed out above by Bill there is no such step required with HFCS and the fructose ‘floods’ the system.

It has always been my philosophy that if you are physically fit the weight will take care of itself. Instead of dieting, which we all know doesn’t work on its own, if you concentrate on fitness and increasing your metabolism everything else will work to your favor. Now, I don’t mean you have to be a gym rat and be overly fit and obsessive about it. But let’s not forget genetic disposition. I have always had a high metabolism rate so perhaps it is easier for me. I also believe that keeping the leg muscles fit is essential to keeping blood flow back to the heart and to prevent pooling of liquids and swelling there. The human body is designed to move so strong legs and a strong heart makes for a strong life. As an aside, whenever I feel unmotivated I simply go to a Walmart and look at all the people in scooters with there bloated legs and fat bodies. If that doesn’t get you moving, nothing will.

Reply to Tom in Florida ==> One thing WalMart does is make it possible for the handicapped — those who need scooters and walkers — to shop for themselves, to get out of the house, and be somewhat self-sufficient. If only other retailers would be as considerate.
That said, I find it almost impossible to make myself enter a WalMart store for any purpose — I have to be dragged in and always rush out at the end.

I am about to enter a WalMart for the first time in a very long time, about a decade, for cheap ISO 22241 Diesel Exhaust Fluid. Eschew Big Box Stores. Shop local, buy local,eat local, brew local. Shop Mom&Pop

I, personally, believe in the war against high-fructose corn syrup. I want that stuff banned because products with HFCS do not taste as good as products with pure sugar. I believe Big Corn has a lot of power, which is why corn ethanol is forced down our gas tanks instead of alternative forms of ethanol or 100% gasoline. Big Corn also spent a lot of money to rename HFCS to “corn sugar”, even spending a lot of money to run TV ads about it. The FDA blocked it on a technicality. I had to drive 40 miles to buy a 12 pack of Mountain Dew with pure sugar. It tastes so much better, I would gladly do it again. Many years ago I had a Dr Pepper with pure sugar and it was the best soda I ever had. I want HFCS gone so that we can have proper sugar in our products again. People have forgotten how much better sugar tastes.

All fructose is bad, not just high fructose corn syrup. This is easily proven – as I and many of my immediate family have demonstrated. If you cut out all fructose from your diet apart from that in a sensible quantity of fresh fruit and vegetables, and use only pure glucose for sweetening puddings, ice cream, cakes etc then you will go on losing weight until your BMI falls to a “medically approved level”. This is partly achieved by the fact that fructose dampens the effect of the appetite suppressant grhelin. If you cut out the fructose you will want to eat much less! Giving up fructose is not easy, however, as all processed foods are full of it – as are fruit juices, smoothies and suchlike. All this is explained in “Sweet Poison: Why Sugar Makes Us Fat” by David Gillespie which is packed with helpful advice as well as with all the relevant scientific research that backs up his theory.

Hugh Davis. Just curious. Where do you get pure glucose in the amounts needed for daily cooking? AFAIK the only sources of glucose readily available in the US are glucose tablets sold in small quantities to some insulin dependent diabetics who have problems with low blood sugar and possibly corn syrup. The former would be too expensive for cooking. The later probably impractical for many recipes.

Reply to Ruminati ==. The issues of sugars and insulin are way beyond the education levels of most readers…and are themselves — when translated to practical application in the human diet of well humans — controversial. As there is no need here to discuss the various pathways the body uses to convert sugars, carbs, and proteins to glucose, discussing normal and abnormal insulin reactions would not clarify why there is a modern Scientific Controversy about sugar.

Insulin works like the thermostat on your AC/Furnace. You have an ideal set point, if glucose exceeds that value insulin is produced to reduce it to the set point. If glucose falls below the set point glucogon is produced to increase it to the set point.
The process is called homeostasis.

the time to READ labels is important
if I make a pasta sauce its tomatos,plus paste, no added sugar, meat onion garlic herbs,pinch of salt or a stock cube and maybe a splash of red wine.
if you buy a commercial version sugar isnt far down the list
and the desired item in ANY food producers menu is one known as “cleanlabel”
ie it does NOT have to be included IN the list so can be quite a range of starches fillers etc
sugar and the fillers bulk up and add gloss to food
if you want to see the “gloss” explained
stew some appleswithout sugar their appearance is sort of flat and possibly grainy
with sugar they look a bit less dull -not much sugar;-)
now add some cornflour paste and reheat
its all smooth and shiny and bulked up and sits IN a piecrust etc better
commercial prepared foods can hold more water due to fillers, and sugar syrup added in makes the bland taste due to lack of REAL food in them, less noticeable.
having some pretty old cookbooks and reading recipies made me notice the HUGE changes in ingredients and sizes of portions considered “normal” today.
a cake using 2 level tablespoons of cocoa powder was considered pretty decadent way back then
now its likely to have half a cup cocoa or some choc goop and 4x the sugar ie from 1/4 to max Half a cup to 1.5 to 2 cups syrup /sugar.

Reading the comments, it seems obvious no one has more than a vague idea how nutrition works, but everyone has a theory or a diet or a philosophy that they are sure is correct. So much for science. It’s more like faith-based eating.

Anyone who has trained for serious competitions knows some things work for them and some don’t.
These blanket recommendations that everybody should do this or that are just bull.
Further the claim that “scientists” know more about nutrition than the rest of us is misinformed. That is why the food recommendations keep flopping around like a dying fish.
Until an independent group is set up to do hostile review of biomedical studies, with an emphasis on identifying incompetence or misconduct we really don’t know what to believe.
AMGEN tried to reproduce 56 landmark (not fly-by-night) studies and only could reproduce 6. 89% of the “Landmark” studies were wrong. Scientists should not place marks on land because they are incompetent and put them in the wrong spot. Applying this to the nutrition field this means that the vast majority of the recommendations are simply wrong.
It sort of is what it is. Until the government mandates hostile review of all government funded studies most of science is going to be a joke.
As long as you make some attempt to balance your diet and don’t just consume cokes, hot dogs, and ice cream you are probably ok.

“Faith-based eating ” – Excellent comment & true … and this is a result of the Diet & Sugar wars & their related wars – it is very difficult for the average busy person to sort it all out & figure out what to do ( if anything) about healthy eating & correct nutrition , thus leaving a “faith-based eating” as the only viable solution for many – science wars in general lead to faith-based solutions / beliefs as good science isn’t being done or isn’t understood by the masses.

Insulin is an anabolic hormone, it causes growth and weight gain. One of the major class of growth hormones in your body are the insulin like growth factors, IGFs. They test pregnant women for blood glucose levels because of gestational diabetes, where persistently elevated insulin causes higher birth weights and potential complications related to large babies.
There is also a counterintuitive link between sugar or protein and cancer/longevity. If you feed a lab mouse a low calorie diet they live longer. I think this represents a dieting/starvation/survival mode. If you eat an excess of food then insulin and higher nutrition cause growth and cancer is just unrestrained growth.
It is also no coincidence that body builders have to strictly limit high Glycemic index foods when they are trying to cut extra weight before a competition. When they’re trying to put on muscle insulin helps them do that but when they want to slim down it works against them.

Marcos this is the list of drugs I was taken two years ago: prednisone and norvasc , metformin, lipitor and antibiotics every 4 to 6 weeks. Today none not even an aspirin. Dr. Lustig video was one of the first I followed and Dr Tim Noakes is my hero.

Wow, so many opinions and no focus on how the bio-chemistry really works. Just a few factoids. Everything you eat is processed by the liver. A tidal wave of fatty liver driven disease is coming to crash our medical system. If you have 2 friends one of you has a fatty liver. Unheard of 40 years ago. Does that matter? Well, only if you develop liver disease. You may not know that there are no medical treatments for cirrhosis other than transplant. 100 million Americans now have a fatty liver. The problem is recent enough that we don’t have really reliable statistics but some estimate that 5 million current citizens will die of end stage liver disease and within the next couple of years it will be the number one cause of transplants. The problem is entirely diet driven. Excess saturated fat overwhelms the livers ability to manage the flow because triglyceride chemistry is complex. Unmanaged fats deposit in the liver putting it at risk. Anything that causes inflammation results in the death of liver cells and the formation of fibrosis ultimately leading to cirrhosis if continued long enough. So where does sugar fit. The fructose that is 50% of table sugar must be processed by the liver. As a poor diet gradually kills liver cells it becomes harder for the remaining cells to succeed and over time the chemistry breaks down and more cells die. Once you put yourself on the toboggan ride to hell of liver damage sugar is not your friend because it consumes processing capacity without a payload of nutrition. Keep it up and you probably die badly. Chronic obesity and insulin metabolic resistance are usually the first steps into the tunnel of illness that is end stage liver failure and diet is what will take you there. As a lifestyle use poly unsaturated fats and limit dietary sugar. Simplest way to live long and prosper if you exercise regularly.

It’s a long journey from fatty liver to liver cirrhosis. Fatty liver is reversible if you shed weight and adjust your diet. If you don’t, chances are that your fatty liver will stay put, without deteriorating into anything worse.
The liver is well equipped for processing the fructose we give it. For a while around the 1970, fructose was even used as a substitute for glucose in intravenous nutrition. That’s right, patients unable to eat received all their calories in the form of fructose. Almost all patients tolerated it well; only a few with enzyme deficiencies did not. So, the scare-mongering about table sugar leading to liver cirrhosis is undiluted nonsense.

Hi Michael,
I’ve always enjoyed your comments on this and other threads.
Are you, perchance, the same Mayo Clinic trained–Rochester, MN–Michael Palmer I did my residency with?
Regardless, all the best
RG

Yes Michael Palmer it is a long journey. It takes decades to develop which is a time scale people fail to assess risk for. Liver damage is a two hit process. The fat makes the organ vulnerable to insults a normal one would manage and fibrosis results. You are correct that a healthy liver is well equipped to process fructose until it is not. The research that explains undiluted nonsense is readily available though I imagine a phrase that strong was just a momentary lapse in an otherwise calm thread.

Wayne, fatty liver is related to total calorie overload, not one isolated nutrient.
You may have heard of the practice of “noodling” geese or ducks. “The feeder sits on a box or stool … grasps each goose in turn holding it between his legs to keep it from struggling as he stuffs it with noodles.” Those birds famously develop fatty liver (“foie gras”), and it’s all caused by starch, not fructose.
Otherwise calm thread, huh? Calm or not, this thread is full of nonsense. Your comment is in good company.

It’s not about the sugars. It is about the carbs. Fat tends to turn off the appetite which is one reason you are always hungry on a low fat diet. Food pyramid and federal dietary guidelines that came in during the 1960s were the current fad of the time. After 50 years, it turns out to horribly wrong. Gary Taubes goes back to the future with his “Why We Get Fat, and what to do about it”. Contains anti-obesity dietary guidelines used medically prior to the 1960s. Worth a read. Cheers –https://www.amazon.com/Why-We-Get-Fat-About/dp/0307474259

So what evidence is there that 50 years from now all of this will be declared completely wrong? None—we know no more than we did 50 years ago, and quite probably less. As for why we get fat, too many calories taken in in proportion to those burned. That’s how it works. It is supposed to be a zero sum game. It really is that simple.
(A healthy diet is a different issue. Coke, candy bars and cheese can be eaten in quantities that don’t add pounds, but that’s a different issue.)

Weight statistics, including obesity, in America, are completely made up. There are annual phone surveys where tens of thousands of people are called and asked their height and weight. Self reporting. No validation.
THEN . . . the government employees adjust the data, based on what ever criteria they wish to use. Government employees whose jobs depend on finding a problem so they can keep their jobs.
In other words, there is no data that meets even minimal scientific requirements.
The Obesity Problem is just noise.

Two independent relevant observations.
1. With respect to development of insulin resistance and its evolution into type 2 diabetes, there is a considerable body of research showing that the problem is exacerbated/directly caused by bloodstream dose concentration swings. T2 diabetes used to be exclusively adult and was called adult diabetes, distinguished from type 1 which is autoimmune related and is almost always juvenile onset and used to be called juvenile diabetes. The prevelance of type 2 in under 18 has grown from near zero 30 years ago to about 20-50% of all juvenile diabetes (race dependent). That is directly attributed to sugered soft drink consumption.
Glucose digested from Carbohydrates like whole grain bread or pasta take longer to reach the blood stream and produce less of a glocose spike. A liquid sugar bomb produces a large rapid spike that taxes the islets of Langerhan which produce insulin in the pancreas.This is the essence of the 2 hour clinical glucose tolerance test. Fast 2-4 hours, take blood glucose and insulin. Drink specific sugar bomb. Take blood glucose and insulin at 30 minutes and two hours. That is yhe definitive diagnostic for the presence and degree of insulin resistance, relevant for dosage levels of drugs like metformin. Other common interventions include exercise, weight loss, and reduction of sugar intake, which can reverse most mild to moderate IR and eventually eliminate the need for drugs. Severe IR usually progresses to T2 diabetes. Drugs like metformin can slow the progression and extend the time before injected supplemental insulin becomes necessary.
2. It is said HFCS is somehow bad. Ignorant ‘science’ like in climate. Table sugar is sucrose. When ingested, it hydrolyzes with water to produce 50% glucose and 50% fructose. High fructose corn syrup used in soft drinks is actually HFCS 55, 45% glucose, 55% fructose. Essentially no difference metabolically. It tastes sweeter than sucrose, so less is needed for comparable taste sweetness. That is good on the margin if one is trying to reduce calories. Better to eliminate soft drink sugar bombs period.

Reply to ristvan ==> It is true that there is research that seems to implicate excess sugar in the diet to Type 2 diabetes, but it is far from proven and is very controversial. There is a great deal of research effort trying to prove that sugar in the diet causes diabetes, but after many many years (and billions of dollars spent) such proof has not been forthcoming. It may not be there at all.
The “links” between diabetes and sugar are hard-wired by biology. The causation of diabetes is not.
Time will tell — but I doubt that the outcome will be “excess dietary sugar causes diabetes”. (with the possible exception of some sub-set of humanity genetically so inclined.)

Yes, we are going backward in our understanding of diabetes. Originally, the belief was sugar caused it. Then an enterprising person figured out insulin had something to do with it—or more precisely, the lack thereof. Then came T2 diabetes and sugar was again brought in as the boogeyman causing the condition. I hope fewer people die due to this belief than died of type 1 before it was understood that it was not sugar consumption, no matter how much it looked like it was.

Diet related health conditions are multi-factoral, take a lifetime to realize,
and are difficult to study and control. And there are multiple factors leading to
similar outcomes. Never the less, fructose is demonstrably difficult to
assimilate, demonstrably screws with hormones which regulate fat storage and hunger.
Given that diabetes costs $1000s of dollars out of pocket and has lots of nasty adverse effects,
( blindness, foot amputations, skin disease, et. al. ) avoiding fructose makes sense.
You will still eat some ( there’s some amount in broccoli ), but cut out the sodas and candies.
Article fails to discuss metabolic pathways.
Article fails to even mention the word fructose.
Article fails to mention insulin, much less leptin, grehlin, etc.
Article fails to demonstrate the change in sugar consumption over time.
More science please.

The only reason we are having these arguments is because most of the epidemic diseases, infections prior to the discovery of antibiotics, improved sanitation, and safe drinking water allow us to get old enough to die in our eighties from nutritional imbalances.
The reason the Social Security retirement age of 65 was chosen in 1935 because the average life expectancy for men (born in 1930) was 58 years and women had an average life expectancy of 62 years. I wonder how much refined sugar was in their diet?

Baloney, MikeC. Up until the 1980’s, there were no gyms, no “workouts,” no one jogged, ran or walked if they had a car. Men worked in offices or factories; women stayed home and did housework. After hours they read the newspaper, talked, socialized. Only THE POOR, who are known to have the WORST health, were doing heavy manual labor for hours every day, like materials handlers and field hands. “Sedentary” is a pejorative term taken to mean “idle,” once again we are in the realm of Secular Virtue. What are they trying to “legislate” via health? You got it: Sloth, gluttony, drunkenness, low productivity!

Life expectancy is a stat that most people tend to misunderstand. This number is an average and is significantly swayed by infant mortality. It doesn’t take many Age 0 or 1 deaths to skew an average way down. We do a lot better nowadays with infant mortality and not surprisingly, life expectancy has increased. But because it’s simply an average you can’t take it to mean that people are living longer and more importantly, with better quality of life.

Carbs do stimulate more insulin and don’t take many calories to digest. But this study of long ago demonstrated that a high carb diet was better than a high fat diet wrt blood sugar and intramyocellular lipids.
Fats don’t stimulate insulin as much, and take a lot of calories to digest, but may lead to insulin resistance.
Proteins don’t stimulate insulin much, provide energy, and take a lot of calories to digest, but too much is hard on the kidneys.
Vegetables provide nutrients, contain fiber, but plants only defense is chemical. The same source of necessary nutrients is full of toxic and cancerous components life long.
Fiber slows digestion and burns calories, slows the ingestion of the contained carbs, and speeds bowles.
But too much can also cause problems.
All foods are bad ( though fructose does probably deserve a place in hell ). The key may be limiting load and fasting more.
People talk about paleo diet and think eating more meat.
But humans of evolutionary past probably went days without finding anything to eat and our bodies are evolved for that reality.
Eat a lot more nothing for your health.

Carbon free sugar. A Limerick.
The Settled Science of Carbon Pollution has reached a new level. Now there is certified carbon free sugar.
Rejoice, diabetics, hear hear!
The Carbon free sugar is here!
No more Splenda for me
I’ll take sugar in tea
It’s Domino’s sugar this year!
(Disclaimer. Maybe, just maybe that is not what they meant?) https://lenbilen.com/2016/02/26/4707/

It figures that they now are at war with sugar. The medical industrial complex is like a yo-yo dieter. They go from one fad to another. The author’s key insight: Sugar isn’t inherently bad, it’s the amount that makes it unhealthy.

I absolutely love the article and the point it makes as well illustrated by the comments that follow. One would expect that basic nutrition would be one of the least controversial subjects, however as demonstrated here and so many other places… nutrition is hotly debated and more polluted with nonsense than just about any other subject.
Unfortunately, or fortunately depending on how one looks at it… the true believers in whatever crackpot idea is in vogue get to experiment on themselves. Most, however talk a good game, but just eat whatever they feel like. Do you remember the Junk Food Junkie comedy song by Larry Groce from the 1970s.https://youtu.be/jQnIL-XPerQ

I hope you’ll also be blogging on dose-response. It’s beginnings with threshold. The rise of linear no-threshold, LNT. The current uncivil war between radiologists and the gate-keepers of LNT. Hormesis and its connection to a decades long research into nature’s cell and DNA repair mechanisms. Three scientific models. One could write a book on it. It’s so shot full of politics and do-gooders, I bet they already saved the world 3 times over in their heads.

The commonality on these science wars is the “warriors” are taking immensely complicated subjects & boiling them down to a few sound bites to support what they “feel”. The more I learn about human biochemistry, the more I skeptical I am about any claims that something is good or bad for you. The systems is just too complicated with too many variable inputs to make simple & sweeping statements. A couple thoughts :
• That being said, “everything in moderation” is probably a good place to start.
• As an athlete, I know sugar effects my performance in different ways in different situations – sometimes for better, sometimes for worse. So the subject for me is not black & white & I would not be a “warrior” for either side. Self-awareness and self control are key .

Its even more complicated, as individualized medicine is starting to learn. There are naturally fast and slow metabolisms. Metabolic rate can be reset with diet and exercise over time. There are natural fast twitch and slow switch muscle fiber predominent body types. Fast twitch football and basketball players, slow twitch distance runners and swimmers. There are genetic disease predispositions like BRCA1 and BRCA2. There are statistically quantifiable racial group predispositions, like American Indians to diabetes, African Americans to (salt) hypertension, and Japanese to stomach cancer (maybe diet also, but same is true for Japanese Americans).
When it comes to nutrition, it pays to remember there are blue, green, and brown eye irises.
A lot of nutritional fads are pure bunkum. Gluten protein is neurotoxic is my favorite. One less one has celiac disease, gluten protein never enters the bloodstream. Digestion breaks protein into its constituent amino acids; it is those that are absorbed and transported. A lot more is just placebo effect, as with many (but not all) health food supplements.

If sugar and other refined carbs are so good for us, why is it that when we eat them our teeth get covered in slime that then turns to hard plaque, which then leads to gum disease and our teeth falling out? We can eat fat and protein all day without building up plaque on our teeth. Clearly our ancestors weren’t eating a high carb diet, else they would have evolved with oral chemistry that handles it. Why grow teeth if your diet only results in those teeth falling out? Natural selection ought to have weeded out carb eaters long ago as we’ve only had dentistry in any form for a few thousand years.

Because plaque tarter is actually a calcifying biofilm made by mouth bacteria who feed mainly on carbs. Archeologists use ‘fossil’ plaque to estimate foods consumed by hunter gather ancestors. Gathering seasonal nuts, fruits, berries, and grass seeds was part of homosapiens lifestyle way before agriculture was invented and cereal crops were developed through selection.

Reply to anarlib ==> Our family dog gets plaque on her teeth and the vet scrapes it off. She doesn’t eat sugars or refined carbs.
Are you sure?
Most dry dog foods contain grain meal and many contain sugar in one form or another.
And check the label. They’ll tell you percentage fat, protein, fiber and water, but not carbohydrate ( which, presumably, is the remainder ). Wonder why. Perhaps marketing to make you think it’s healthy.
The percentage carbohydrate on many is around 45% – probably not good for the dog,
but a trade off between price and nutrition.

But I’ll bet she eats kibble, and that’s grain-based; not a canine’s natural diet. I keep my pack of five’s teeth plaque-free by letting them chew big cow bones fresh from the butcher a couple times a month; they literally disappear under that immense jaw strength and equally astounding stomach acid! Putting a dog “under” for teeth-cleaning I’ve always thought was unjustified; but then, my guys live outside! 😉

My dogs eat meat, eggs and offal – they have brilliant white teeth with no plaque. I wouldn’t let them eat something I wouldn’t eat myself. Dog and cat kibble is pretty terrible, it’s full of crap that no animal in it’s right mind would eat in the wild. And that’s why you never see animals in the wild that are obese but it’s commonplace with our pets. The food most of them are fed does horrible damage to them.

Reply re doggie dental plaque ==> The subject is controversial, even among vets (who may offer teeth cleaning services and thus may be biased by the profit motive — this is not an accusation, vets, so no flaming, please). (Hardly on topic though…)
The American Vet Assoc says “Several “dental diets” have been shown to be of benefit in decreasing dental disease. Some employ a specific kibble design and others include a chemical anti-tartar poly-phosphate ingredient. Rawhide products and chew treats can be helpful if chewed daily, and some rawhide chews and biscuits contain an anti-tartar ingredient. Palatability is important – chewing every day is the ideal.”
Another site praises the value of raw meaty bones.
A third says “Studies show that hard kibbles are slightly better than canned food at keeping plaque from accumulating on the teeth. There are veterinary dentist-approved foods and treats on the market that have shown that dogs eating these foods have less plaque and tartar build-up.”
Take your pick.
Generally, as a past pet professional (breeding, raising, and retailing), my opinion is that feeding and care of pet dogs (house pets, lap dogs, kid’s dogs) varies from that of working dogs — and each have their own best practices. I fed raw bones as part of the regular diet of working dogs with good results. Our house dog, a lovely little Basenji named “Jude”, received high-grade kibble intended for smaller dogs and proper chews for dental health, with good, but not perfect, results, albeit she has never had any dental or gum problems.

Obese pets certainly may be so because of the ingredients in processed pet chow. However, its more likely due not to content, but due to the amount they consume. Wild carnivores never become obese because of intestinal parasites, disease, missed meals, inter and intraspecies competition and the obvious caloric expenditure associated with chasing and killing each meal.

Kip Hansen
Thank you for your efforts to inform instead of inflame.
As you are probably aware, the publicity and policy makers’ alarm regarding obesity and the associated increase in sugar consumption began in earnest at the stroke of midnight, January 31st, 2000. That was when the measure of body weight vs height, the Body Mass Index (BMI) became standardized globally. In doing so, specific cutoff values were made and agreed upon. The data of weight, height and blood pressure was accumulated since 1971 and reported as the the first National Health and Nutrition Examination Survey (NHANES), with the surveys becoming an annual event in 1999 and the first report on the topic published in 2001.
Influential policy consultants set the goalposts, not quite in keeping with the data. Instead, the normal BMI became 25 became were characterized as “over weight”. A BMI of 30 became obese when the data said 33+ and so on. The metabolic syndrome, diabetes, hypertension were recognized as issues for people with BMI 40+. In addition, the data said that people with a BMI >27 and <34 lived longer than those with BMI <27. The Obesity Paradox was created by moving the goalposts 2+ points downward.
The sugar story, and the high glycemic index foods; i.e., those foods high in sugar, rapidly absorbed causing a spike in blood sugar and an insulin response that shepherd the glucose into cells to be made and stored as fats, are part and parcel of the grain foods we eat, bread, bagels, and pasta let alone the sodas etc. All sorts of fad diets were manufactured with the premise that grains are good and fats are bad, all except Adkins of course who died of a head injury from falling on ice on the sidewalks of NYC.
The Sugar Wars really need to include eliminating breads, bagels, pasta, and all but the indigestible grains if we really are going to deal with the obesity epidemic. Or, we could of course, revert back to the recommendations of 6 people, way back in the 1941, charged with making nutrition recommendations for a nation on a war footing, studied the literature and came up with the Recommended Daily (or Dietary) Allowance (RDA).
A balanced diet: 1/3 calories from carbohydrates, 1/3 calories from fats and protein, 1/3 calories from fruits and vegetables. Still good today as yesteryear. Try it, you'll like it.

Reply to RiHo08 ==> Thank you for your support. My favorite diet advice was given by a man who I knew personally and who was a “functioning psychotic” (don’t ask).
Here it is: “Eat your chow!”
My wife and I recently returned from a ten year stretch of humanitarian work, mostly in the Dominican Republic — mostly with the profoundly poor — where the concern was having something to eat..
All the hub-bub here is from people who have [almost certainly, always exceptions] never been truly hungry due to lack of food.
I would guess that 80% of the world’s population are not concerned with what they eat, but with the question “Will I get enough to eat today?”

“1/3 calories from carbohydrates, 1/3 calories from fats and protein, 1/3 calories from fruits and vegetables”
The calories in fruits and vegetables are also carbohydrates (mostly), proteins, and fat. They are not a separate category. So, this “recipe” is a bit vague.

The above article is completely incorrect. Hansen’s and most of the general population’s ideas concerning nutrition is based on urban legends such as the assertion that ‘all calories are the same’ which is absolutely incorrect.
The diet urban legends are and were created by the Food ‘group’ industries (to protect their food group’s market share, such as the get cracking, egg ad campaign which the FDA was forced to stop, consumption of 2 1/2 eggs a week results in a 81% increase in lethal prostate cancer for example), the ‘Dieting’ industry (the solution to obesity is a change in diet not caloric restriction, dieting) and the ‘Diet’ industry (For example the Paleo diet is not the optimum diet based on three decades of research.)
The optimum diet (based on three decades of research) for humans reduces the risk of all of the common cancers by roughly a factor of 4 and is the ‘cure’ for most of the Western diseases such as metabolic syndrome. How is it possible that the majority of the population is clueless about how diet affects health?
The consumption of industrial sugar, alcohol, and/or fruit juices (consuming whole fruit is completely different than consuming fruit juice) is the primary cause of fatty liver disease which inhibits the normal functioning of the liver which causes a number of health problems including high blood pressure and excess sugar in the blood (due to the fat in the liver, the liver’s response to insulin is reduced which causes excess sugar in the blood stream). Fatty liver disease causes a multitude of health problems and will eventually lead to liver damage. This set of health problems caused by diet is called metabolic syndrome.
This is a link to a site that provides an excellent holistic in depth review (explains for example how the researchers test different hypotheses) of the most current nutritional/heath research.
The information is presented in short 4 to 7 minute videos with links to the new and old peer reviewed papers (that support the video summary, with quotes and data from the paper in question) explaining how the theories have changed or not changed.
The “twin vicious cycles” explain how the buildup of fat in the cells of our muscles, liver, and pancreas causes type 2 diabetes, which explains why dietary recommendations for diabetics encourage a reduction in fat intake.http://nutritionfacts.org/video/diabetes-as-a-disease-of-fat-toxicity/http://nutritionfacts.org/video/eggs-choline-and-cancer/http://nutritionfacts.org/2014/08/21/why-the-egg-cancer-link/
How much whole fruit consumption is too much?http://nutritionfacts.org/video/how-much-fruit-is-too-much/
This is a link to a couple of additional papers that deal with the issue of fructose in the diet.http://www.ncbi.nlm.nih.gov/pubmed/22129639

The role of fructose-enriched diets in mechanisms of nonalcoholic fatty liver disease.
Nonalcoholic fatty liver disease (NAFLD) currently affects 20%-30% of adults and 10% of children in industrialized countries, and its prevalence is increasing worldwide. Although NAFLD is a benign form of liver dysfunction, it can proceed to a more serious condition, nonalcoholic steatohepatitis (NASH), which may lead to liver cirrhosis and hepatocellular carcinoma. NAFLD is accompanied by obesity, metabolic syndrome and diabetes mellitus, and evidence suggests that fructose, a major caloric sweetener in the diet, plays a significant role in its pathogenesis. Inflammatory progression to NASH is proposed to occur by a two-hit process. The first “hit” is hepatic fat accumulation owing to increased hepatic de novo lipogenesis, inhibition of fatty acid beta oxidation, impaired triglyceride clearance and decreased very-low-density lipoprotein export. The mechanisms of the second “hit” are still largely unknown, but recent studies suggest several possibilities, including inflammation caused by oxidative stress associated with lipid peroxidation, cytokine activation, nitric oxide and reactive oxygen species, and endogenous toxins of fructose metabolites.

The role of fructose in the pathogenesis of NAFLD and the metabolic syndrome
Nonalcoholic fatty liver disease (NAFLD) is the most frequent liver disease worldwide, and is commonly associated with the metabolic syndrome. Secular trends in the prevalence of these diseases may be associated with the increased fructose consumption observed in the Western diet. NAFLD is characterized by two steps of liver injury: intrahepatic lipid accumulation (hepatic steatosis), and inflammatory progression to nonalcoholic steatohepatitis (NASH) (the ‘two-hit’ theory). In the first ‘hit’, hepatic metabolism of fructose promotes de novo lipogenesis and intrahepatic lipid, inhibition of mitochondrial beta-oxidation of long-chain fatty acids, triglyceride formation and steatosis, hepatic and skeletal muscle insulin resistance, and hyperglycemia. In the second ‘hit’, owing to the molecular instability of its five-membered furanose ring, fructose promotes protein fructosylation and formation of reactive oxygen species (ROS), which require quenching by hepatic antioxidants. Many patients with NASH also have micronutrient deficiencies and do not have enough antioxidant capacity to prevent synthesis of ROS, resulting in necroinflammation. We postulate that excessive dietary fructose consumption may underlie the development of NAFLD and the metabolic syndrome. Furthermore, we postulate that NAFLD and alcoholic fatty liver disease share the same pathogenesis.

It is interesting that the researchers have worked out many of the mechanisms which explains why diet is responsible for roughly 70% of all Western diseases. This is a link to a one hour presentation that explains the research to support that assertion.
This is a great starting point to understanding what is or is not the optimum diet and to understand the mechanisms.
http://nutritionfacts.org/video/uprooting-the-leading-causes-of-death/

Sorry William but all calories ARE the same. A calorie is not a physical thing, it is a unit of energy measurement, it describes how much energy your body could get from eating or drinking. All the other factors of how certain foods act in the body of course come into play but a calorie is a calorie is a calorie.

I think this is an important semantic issue that causes a lot of needless argument.
One calorie equals one calorie. As you say, it’s a measurement of energy.
But food of type A with a calorific value of 1 is NOT equal to a different food type with the same calorific value.

MIke, I think you are adding to the confusion with “caloric value”. Because calories are a unit of energy, you can compare energy values but not food types. For instance, 100 calories of lettuce compares energy wise with 100 calories of butter but obviously the amount you would need to eat of each to attain those calories is vastly different. Calories are simply a way to measure energy in and energy out. But that does not do much to explain where the calories are coming from or the other factors from the type of foods eaten that influence overall well being.

I put on 10-15 pounds of extra weight. I knew it would happen, but one pays the price of doing business. On return home, to home-cooked meals and more choices, I readily dropped the extra weight.

that isn’t the entire story – as you will learn when your glucose tests come back warning you of diabetes
sorry if that ruins your analog to CO2 – but CO2 is nowhere as pernicious as sugar – you made an unfortunate choice of topic
the diabetes threat is real – http://www.diabetes.org/diabetes-basics/statistics/?referrer=https://www.google.com/ – i used to be as blasé as the author – but as a pre-diabetic – i no longer am

Reply to JEyon ==> Thanks for the free medical opinion. However, I have been getting regular blood work annually since I passed 60, most recently four days ago, and do not suffer from blood glucose problems — neither high or low — nor do I have any form of diabetes, not even the newly invented “pre-diabetes.”

Hi Kip, you put a lot of effort into your post and when I was your young age I would have probably agreed with all of it. I had never had, nor have I yet 5 years later, had a questionable blood test. However, I did learn to my dismay that I had joined a surprisingly large number of people diagnosed with cirrhosis with no prior warning after carefully building a fatty liver for decades. As someone in the actual battle my advice is not to take too much comfort in that blood work. I’m a technical person so research is second nature to me and I can assure you that the state of evidence doesn’t exonerate sugar as a dietary hazard. The process is vastly more complex than a discussion of glucose and a climate blog is an odd place to have this thread. In simple terms however, minimizing saturated fats and sugar will be beneficial for your liver and overall health. Obesity is epidemic and the damage isn’t only that you have to buy bigger clothes.

Reply to Wayne Eskridge ==> I hope you have read the entire essay. If you missed it, I am over 65 and retired after a very active life. I am sorry that you have been diagnosed with cirrhosis.
I have not said that morbid obesity is not a health hazard.
Read the last link in the main essay [ link ] . It is the latest topic-wide meta-analysis of research on dietary sugar.
The Conclusions starts with this simple statement:
“There are epidemiological data, plausible mechanisms and clinical data from diet intervention studies that provide strong support for a direct causal/contributory role of sugar in the epidemics of metabolic disease, and for an indirect causal/contributory role mediated by sugar consumption promoting body weight and fat gain. Yet, these are still controversial. ”
The posited causal/contributory roles are based on the relationship between sugar and obesity for the most part — yet the strongest statement that can be made is “strong support”….the authors don’t even find that sugar a direct cause of weight gain or fat gain — only “strong support” for an indirect causal/contributory role.
That is weak evidence indeed.

You’re making the assumption that a fasting blood glucose under 100 is a sign of health, it’s not. Your fasting glucose can be “normal” but the problem is that blood glucose can take a decade or more to show up after metabolic issues arise. I find that Dr. Joseph’s Kraft’s work on insulin is much more telling when it comes to being a diabetic as insulin is a leading indicator, unlike blood sugar. I hate to put it so baldly but your coronary issues indicate you have serious metabolic issues.
A writeup of Dr. Kraft’s work can be found here:http://www.thefatemperor.com/blog/2015/5/10/lchf-the-genius-of-dr-joseph-r-kraft-exposing-the-true-extent-of-diabetes

kip – glad you are still diabetes free – but a lot of people aren’t – and no one should base the global situation on any one person – (like I shouldn’t have based my prediction of your health on mine)
never the less – i still contend that your CO2 / sugar analogy is a false one – unless you’re willing to admit that more CO2 is dangerous to some people but not others (a not too unreasonable assumption – i suppose)

Reply to JEyon ==> What “CO2 / sugar analogy”? There is no mention of CO2 anywhere in my essay (I know, I wrote it) and there is no point made meant to be taken as any sort of comparison of the details of MSC (controversy) regarding sugar with the MSC over Climate. Have you carefully read the essay? and the two preceding essays in the series? You are the only person who has mentioned CO2 here today — including in ALL of the comments — I am somewhat flummoxed as to how you arrived at your idea that some analogy was being made between CO2 and Sugar.
What this series of essays is about is Modern Scientific Controversies (MSC), which Kahan has recently been calling “The Science Communication Problem” (see the prologue at the beginning of the essay),
By researching and writing about a number of MSCs, I hope to illuminate the common factors shared between them. Why? Simply because these MSCs harm the reputation of science and prevent the communication of good science to the general public.

kip
indeed – you didn’t mention CO2 – it was my mistake to think that on WUWT – you used an anlalogy to sugar to demonstrate the fallacies used by the Alarmists
maybe it’s statements like “The proponents of the War on Sugar – those fighting to eliminate — or at least sharply reduce the amount of – sugar from the American diet have painted sugar as bad – have made sugar into a villain” that fooled me since substituting “CO2” for “sugar” would work really well

If you’re asymptomatic, STAY AWAY from doctor visits for “drawing blood” for the purpose of speculative “diagnosis,” aka lifting up rocks to try to find “disease” or “pre-disease.” NO DOCTOR = NO PROBLEM!
Most of this crap is nothing but a cultural construct to make MONEY.

Ah, yes, the ubiquitous Scary Anecdote! Sorry dude, no sale. I’ve worked with animals my entire life enough to know that when the body, man or beast, has a serious problem afoot it generally lets you KNOW. Google the symptoms for Type II diabetes, and the risk factors–which are mostly genetic.
Generally speaking, the 80-15-5 rule holds sway: 80% of the time everything’s fine pretty much no matter what you do within reason. 5% of the time Nature calls your name and it’s game over regardless. Only 15% of the time is what you do, when, and how really a game-changer.
I’m not a big believer in the boogeyman known as The Silent Killer . . . but it makes great marketing of fear.

One final comment that applies to things like salt and sugar. Individuals differ. A lot. Some people are born diabetic. Perhaps dietary excesses of one sort or another cause some folks to develop metabolic disorders like diabetes. And in all likelihood, some people are genetically programmed to develop problems like diabetes,strokes, heart disease as they age. One size fits all dietary “solutions” probably won’t work except for some population subsets. If they work at all. For anyone.

I bet all the people who died from high blood pressure, undiagnosed diabetes, etc, all said the same thing. It’s fine to have screenings for problems. You don’t have to do what the doctor says (assuming there is a doctor involved—some places screen without involving a doctor) if you don’t want to. You can research the condition (hopefully using actual research and not internet blogs_ and decide what to do. You may believe ignorance is bliss, but that’s only until it kills you.

In some ways, this piece is correct.
People like a single factor cause when multiples are at work.
People in the 1800s did manage to get fat without access to all the sugar we consume today.
And diabetes is written about through out history.
However, there are good reasons to believe fructose is a large factor ( not the only factor, but a major one ) wrt to fattty liver disease and ultimately diabetes.
Wrt global warming, there are industry bugaboos:
Ancel Keys was funded by the sugar industry to say fat was the cause of heart disease.
But Ancel Keys also distorted the science and bullied his way into organizations, similar to the IPCC.

Hi Eddie, your fundamental interpretation is on target. Anything that leads to inflammation, as both alcohol and fructose do, have the potential to kill liver cells and if the concentration exceeds the liver’s capacity to clear the brewing fibrosis the path toward liver failure is traveled a bit further. The liver has an amazing repair capacity but we can certainly defeat it and there are few warnings prior to serious damage.

There is a j curve relationship between alcohol content and all causes of mortality after 20 units approx per week for men it starts to go up before that it goes down. There was a big debate recently in the uk when the recommendations by the chief medical officer went down from 21 to 14 units per week for both men and women. The potential result? Well, total credibility wipe out. In five years it will also be zero units.

Once again, they are now trying to regulate via “health” the identical behaviors (i.e., drinking) that were once under the MORAL rubric of The Church. Sloth, gluttony, intoxication, sexuality. “Health” is the new, secular, Church of Immortality. The extent to which otherwise intelligent people have swallowed this wholesale continues to astound me! Just like the High Church of CAGW!

This stuff ( hyperbolic rhetoric ) is justified though by these same hysterians claiming that they need to exaggerate in order “meet in the middle” I hear that crap over and over again no matter if it’s our diet, the climate, or whatever. When pinned down with facts the response is always the same, ” I know but if we don’t get people’s attention nothing will change.”
So don’t look for any changes soon. Lies and exaggeration are deemed righteous.

I believe that some of the concerns about the sugar content of the modern diet are justified.
The increases in obesity and related diseases does correlate with the increasing sugar content. I agree causation has not been confirmed.
The “low-fat” fad has also led food processors to add large quantities of refined sugars to many foods.
There is some evidence that sugar may be mildly addictive.
For myself, I have sought to cut back on foods with added sugars, and increased the quantity of fresh fruit I consume (dramatically). I have lost weight, feel enormously healthier and my Doc is thrilled with the impact on my blood work.
But I completely reject the need for a “war” on sugar and most of the rest of the mainstream media hype surrounding sugar and diet in general. I do believe that eating less refined sugar and more fresh fruit is something that would prove helpful for the vast majority of Americans. Having said that, I passionately believe these decisions belong to the individual.
We don’t need no stinking soda/sugar tax as a means for the elites to take our money for themselves while professing to “help” us.

Reply to Mike Smith ==> There is always some justification for most public health ideas. The 350 lb. diabetic truck driver who stops at a truck stop for a 64 oz. carry-out cup of full-sugar soda six times a day really ought to cut back on his added-sugar intake.
The idea that sugar is addicting is nearly utter nonsense and is based on the mostly false ‘science’ of functional MRI., which has been found to have a error rate — false positives — of 70% — on top of the usual study design flaws and “finding what we are looking for” bias.
If you haven’t been eating your fruits and veggies, starting to do so will improve your blood tests. If you were eating Snickers as a treat and switched to an apple as a treat, you haven’t gone wrong.
I personally doubt that manufacturers are to blame — not for adding salt, not for adding sugar.
Opinions vary wildly. The science is still very uncertain — you can bet the farm that no single substance is to blame for any of it.
Your grandmother was probably right — eat everything on your plate (she meant a well rounded diet, spinach and all, fruit pie for dessert, because that’s what she was providing.)

Perhaps you could provide the health evidence for the so called 5 a day campaign, there is none of course. Also fruit and veg are different foods. Interestingly people eat more fruit as it preferred to e.g kale but it’s still part of your 5 a day. I haven’t eaten fruit for two years, well Goutboy says it all!
Just to say I would have thought the sat fat wars were a better bet much more evidence, much more intrigue, longer time, relates to big pharma re cholesterol. Sugar wars are just a side battle it might get hotter but not for some time, not while cholesterol still to blame for cvd and a replacement for statins is being pursued. I also think the parallels between the global warming nonsense and cholesterol are obvious. I think it was yourself who said that without the humble beginnings through the Internet there would be no debate on AGW. The same goes goes for cholesterol and cvd. All power to the blog.

“Your grandmother was probably right — eat everything on your plate (she meant a well rounded diet, spinach and all, fruit pie for dessert, because that’s what she was providing.
My grandmother, a nurse, died from Type II diabetes, but only after going blind and having several amputations.

Reply to Bob Johnston ==> Sorry about your grandmother.
It is an oddity that if one drives by a modern hospital, one can still see nurses out behind the hospital, smoking cigarettes on their breaks. Being a medical professional doesn’t automatically mean one will chose healthy life habits.
One of mine was a Wisconsin German dairy farmer’s wife and served four meals a day to the family and farm workers, lived into her 90s. The other was a Baptist missionary’s wife — round as a butterball and lived happily into her late 80s.

My point was simply that Grandma’s bromides should be taken with a grain of salt rather than a guideline for how to live our lives.
I recently went to the emergency room for treatment of a deep laceration, I wasn’t surprised to see that every single nurse in sight was grossly overweight. Quite possibly it’s an effect of shift work under “blue light” but I think it highly likely that it’s because they actually do follow the government advice to eat low fat and a large dose of whole grains. Just a hypothesis, but it would be a really interesting study.
And while I’m at it I think I’ll share my personal story here:
Ten years ago I wasn’t a critical thinker, I believed that “the experts” had it right. I didn’t know the difference between an observation study and a randomized clinical trial, the difference between absolute risk and relative risk or anything else necessary to determine the relevance of scietific endeavors. The housing crash cured me of that, all the experts said prices could keep on rising but being in the homebuilding industry and seeing how people were actually “affording” these homes made me understand just how FOS these experts are. That led me to wonder what else my faith in experts was leading me down the wrong road.
At the time I was 30 lbs overweight, asthmatic, was near-sighted, had hand tremors and hayfever and this despite eating a low fat, low sugar diet full of “healthy” whole grains. Why was I sick and getting worse if I was eating healthy and exercising (weight lifting and mountain biking). I had lost weight before using a low carb diet but because all the experts said it was unhealthy and I didn’t want to become a slender corpse I switched back to the very diet that found me fat in the first place (yes, I was that dumb).
Ten years of study has led me believe that nutritional science is just as effed up as climatology, it’s rife with cognitive dissonace and confirmation bias and why wouldn’t it be? Researchers are generally smart people and the smarter you are the more susceptible you are to falling for the notion that a belief you hold cannot be wrong. And this showed up time and again in the studies promoting a low fat. high carb diet as the way to eat for good health. Low carb diet studies time and again show them superior to for weight loss and risk factors. But these get ignored because people are unable to change their minds.
Today I am not overweight despite never counting calories. I eat when I’m hungry, I just don’t eat foods (hard to call them that) that I know will cause an insulin response. I am no longer asthmatic, my hand tremors are gone, my vision has improved to the point where I tossed my glasses (actually the dogs ate them and I never replaced them) and I don’t suffer from hayfever anymore. A miracle? No. Just a simple change in diet that reduces insulin production. A year ago I had lab tests done (you can get them done directly with online labs rather than see a doctor, they’re quite cheap this way) and the results are pretty darn good if I say so myself:
Triglycerides – 55mg/dl
HDL – 66 md/dl
Fasting insulin – 6 (I forget the units)
Fasting blood sugar – 83 mg/dl
These are the marker si think are important, both total cholesterol and LDL-C aren’t very predictive markers at all – mine were normal (although LDL-C from a basic lipid test is wildly inaccurate when triglycerides are under 100 or over 400 because it’s calculated using the Friedewald Equation rather than actually measured) so I really don’t know what my LDL-C is, and don’t care anyway.
Sure, I understand this is just an anecdote but what’s funny is that it becomes the same anecdote for everyone who I convince to try a low carb diet and intermittent fasting. But it is what it is.

I’m not sure what the point of publishing this article was.
I don’t want sugar or anything else banned/taxed/demonised but if you eliminate or minimise GPS (grains, pototos, sugar) from your diet you will lose weight. My wife (former RN) has done considerable reading on the subject. It seems clear that Ancel Keys was a charlatan in his demonisation of saturated fat.
Dr Lustig gives you the clues about fructose in his video linked here by a couple of commenters.
Run the experiment. My wife and I have for the last two years. We never were fans of sugar but did like pasta and bread. Cut that out and I lost 10 Kg (77 kg down to 67 Kg), she lost 3.5 kg (53 Kg down to 49.5Kg). Blood work shows slightly higher total cholesterol but high density up, ratio of high to low much better, triglycerides down, fasting blood sugar completely normal. I’m not going to argue against experimental data.
If you were reading Karl Denninger at http://www.market-ticker.org/ before it went black you’ll have seen lots of similar stories. Likewise read Dr Malcolm Kendrick.
Looking at what waddles around supermarkets nowadays and looking into their trolleys when they are in front of you in line at the checkout should give you a good clue about sugar and getting fat.

Reply to Mike Borgelt ==> Thank you for sharing your personal experiences with weight loss. The weight loss world is filled with similar anecdotes — using hundreds of various and different specifics. Your story is that you and your wife lost weight by cutting bread and potatoes. Well done.
My story was cutting restaurant food and sugared soda — repeatedly losing those extra 10-15 lbs.
The Obesity Wars are all about what does and does not work. You’ll see that there really is no single answer — we do not yet really know what causes obesity. There will be an essay in this series on the Obesity Wars.
Sugar, in the diet, after all the research done over the last twenty years, has only been found to be “supported” as an indirect or contributory cause of weight gain and fat gain. In other words, it hasn’t been ruled out, but it hasn’t been shown to be a primary cause either.

We think we know a lot, but we are actually staggeringly ignorant about how our bodies work, and about how varied the function is.
Otherwise it wouldn’t have been such a shock when a study centering around treating obesity and diabetes with a variant on gastric bypass mysteriously cured a number of patients of diabetes in Germany (research is ongoing, they don’t seem to know quite how they did it).
Not to mention genetics, epigenetics, gut flora, blah blah blah. Oh and my favorite Adenovirus 36.
Unfortunately, people tend to laser in on one subject (calories, fat, sugar, exercise, protein, etc) and since our general knowledge of the subject is based on oversimplifying an incredibly complex system (with the legitimate goal of trying to break a subject down into bite-size pieces than *can* be understood). That means our overall progress is painfully slow.
On top of that, people tend to “politicize” or “moralize” their ideas, too (conspiracy theories about marketing and government standards, blaming things on TV or laziness or whatever).
And on top of *that* somebody’s always trying to sell you on a miracle food or diet, either to make money or because “it worked for them” for whatever reason.
In the end, the average person is just surrounded by shouted contradictions and the average fat person is just discouraged because nothing seems to work (especially being shouted at).
Someday, provided we don’t all descend into Noth-Korean-Style prison-statism or nuke ourselves to oblivion, we’ll probably get a handle on the genetics, epigenetics, hormones, gut flora, and on and on that control why two people of similar builds can eat the same amount, exercise the same amount, and one is skinny and one is fat (yes it happens).
Until then, we’ll probably just fight endlessly and judge each other harshly, as per usual.

“All of us who have studied and trained ourselves to read health studies and findings see right away the problem here. The finding of “links” (direct or not) between two or three things is [almost] meaningless. To then make society-wide health or diet recommendations on this sort of weak evidence is not scientific.”
~Kip Hanson

The anti-sugar activists could conceivably perform an experiment on themselves; they could give up their alcoholic beverages every night. Those are fermented with sugar. Then they can get back to us with their results, improvements in mental clarity, and weight loss.
Very nice article. Thank you.

Kip Hanson says, “…and try to side with strict science.”
I appreciate your rolling up your sleeves to do that, esp. with the wide reading and historical perspective.
What strikes me about sugar is its usefulness. Any one who has fruit vines and trees understands that you can only dry so much fruit. Sugar is a wonderful preservative for all the apples, figs, cherries and grapes that start getting ripe starting about now, plus some of the wild berries. It gets ripe all at once and the sugar and the canning process allows us to preserve it. Without this, there would be tremendous waste.
Sugar beets grow in the north well, and the pulp and tops are excellent feed for animals like goats and dairy cows.
Every loaf of bread requires about 3 tbs of sugar. Just a small amount can do wonders for a cup of coffee or tea, and of course there is the matter of chocolate. I suppose I have only scratched the surface but I do wish that people would remember to give thanks for food instead of getting so upset. It all just amounts to the power of negative suggestions.

The author seems not to be aware of two important ways the debate is even more insidiously fraudulent than he describes.
1. The “obesity epidemic” itself is non-existent, or greatly overstated. Body Mass Index was expressly stated by its creator to NOT be a gauge of health and/or percentage body fat. It does not differentiate between lean muscle and fat. There is no place for BMI in the discussion of healthy body composition. Stating one’s own BMI, as the author does, lends legitimacy to a false diagnostic.
2. The author has been trained in the falsehood that a high-sugar diet is “bad.” Read the CNN (and other) article regarding the Professor of Nutrition who went on a “Twinkie” diet of convenience store food and multivitamins and not only lost weight (as one always does when starting any new diet, because of water loss and attention to caloric intake) but improved his cholesterol profile. He demonstrates how little we understand our bodies’ real needs despite making endless pronouncements and rules.http://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor
Bonus note: In earlier times, sugar was demonized for causing children to become sexually aroused. There has always been a war on anything that tastes or feels good. Crazy has always been with us.
Otherwise, thanks for a good essay!

Common sense is your best friend. Of all the nutritionist hoopla, there is a single article that I can support and recommend, “Unhappy Meals” by Michael Pollan. Over 97% of the rest is garbage.
As for cavities, my 13YO son have grown into a healthy young lad with zero cavities and zero interventions on his teeth. We concluded that tooth cavities are a “hereditary” disease inherited by means of transferring parents’ saliva into a babies mouth. My teeth are a nightmare on Elm Street, my wife’s a zombie apocalypse, yet my son’s teeth are all healthy. And yes, he has LOTS of sugar every day.
Guess most of “genetically predisposed” diseases are also some kind of a parental transfer of pathogens, with zero involvement of genes.

For most of human history, fatness was not considered a negative trait. It was a sign of wealth; it meant your family could afford regular meals. The lean, hungry poor ate what they could grow, steal, or glean.
In our time, an ironic reversal has occurred in the West. Our poor can eat like kings and put some meat on their bones, while our rich all-but starve themselves on the latest fad diets and supplements to try and stay as lean as possible.

Fruits are mostly fiber, sugar, and water. Vegetables are mostly just fiber. Our digestive system cannot handle cellulose, of which plants are composed, with the result that what comes out is pretty much like what went in. That’s your “5 a day!” THE POINT which the “experts” all keep dancing around since they can’t (economically and PC speaking) come out and say it is: ANYTHING you eat instead of refined, processed starches and sugars is likely to advantage your health! That would include wood chips if you could chew them! Believe it or not, one hamburger of even indifferent quality contains more essential nutrients, more antioxidants, more of every single building block the body needs than practically that whole truckload of “veg.” WE EVOLVED AS CARNIVORES during the big glaciations–can’t argue with evolution.
So I like to say I’m a second-hand vegan: Cows eat grass, I eat cows! 😉

Reading through all these absolutely definitive statements on sugar, fructose, insulin, etc, I am forced to ask:
Why is there no perfect system for type 1 diabetics that keeps their blood sugars 100% in the normal range. If science knows so very, very much and so very, very exactly about all of these things and how they work together, then why are millions of diabetids struggling to balance insulin, activity, and food? Where’s that magic answer that so many preach? Cause I”m not seeing this in the real world.

Hi Reality check, – Type 1 diabetics can die from too low blood sugar (hypo-glycemia = 70mg/dL) & 4-10% of Type 1 diabetic deaths are a consequence of profound hypo-glycemia (< 55mg/dL = brain function impaired). Since they do not make insulin (unlike Type 2 diabetics) too high blood sugar is hard to reign in; I presume you meant to write Type 1 diabetes.
There is no "one size fits all" diet that can constantly balance the Type 1 diabetic individual's changing activities/functions to supply just the right amount of blood sugar. They risk brain seizures if run out of blood sugar & they can't over-compensate via dietary high loading their blood sugar as emergency back-up; because without insulin they risk other medical complications.

Yes, I am aware of this, only 55 mg/dl is a bit high for profound hypoglycemia in most diabetics. One can get down to a meter reading of 21 mg/dl and still be coherent and ask someone to fetch you some sweetened juice or pop. One must indeed always carry sugar in some form. It’s great you know that low blood sugars are very dangerous and the results of this. That seems to be overlooked frequently.
I know there is no “one size fits all” diet. My question was why if we know so much can we not create one? I can’t see that we know much at all about insulin, food and exercise and how they interact.

That is because there is no absolute definitive on the subject.
Medical Science is hardly exacting and while what might work for most people will not work for some in regards to intake of foods and drugs. Does this lead to researchers placing ‘can’ or ‘might’ in their comments due to the large variations of potential results?
Of the three ‘wars’ done so far this has to be the least informative of the war itself. It seems more like a bash one side of the war without dealing with how the science (or those claiming to know the science of sugar) developed into the problem of limiting our overall understanding of how sugars affect our bodies.
Prior to the current trend of beating up on sugar it was the opponents of sugar who were systematically attacked in the 60s-80s via ‘sponsored’ scientists such as Keys, or at least that is what the anti-sugar types are saying and there are plenty of documentaries produced on that aspect.
Where this differs in climate séance is that many of those who claimed an ice age was coming in the 70s then moves to globull warming in the 80s following the gravy train of activism rather than the scientific method. You generally didn’t have prevailing wind type scientists that jumped to where the government money is in this argument. Drawing parallels to Tobacco in the strategies of the respective sides and timings would indicate very high similarities.
There are also recent research still showing the negative aspect of sugar in the Dopamine reaction the body takes to elevated intake of sucrose.http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0150270
Diabetes is a more difficult question. Small studies exist, for example, of groups of indigenous people, who are in a far higher at risk group than non-indigenous groups in countries like Australia, show remission of their diabetes if they returned to their natural diet. Did they get more exercise? Was alcohol also an issue for this group etc wasn’t explained in what I had seen.

Kip, AFAIK the first thing starches and grains do when they are eaten is turn to sugar.
I’m all in favor of eating grains – as long as they are cycled through a cow first.
As ever, the dose makes the poison. The “war on sugar” is really about EXCESS sugar consumption, much of it inadvertent because people simply don’t realise it is added to just about all processed foods, even when it isn’t necessary to make foods palatable.
I’ll stand by my comment about what I see in supermarkets.
Type 1 diabetes used to be treated by low carb (sugar is a carb), high fat, moderate protein diet which prevents spikes in blood sugar levels. Nowadaysit seems by high carb and balance with insulin. I have a friend who is Type 1 and was very careful with sugar and insulin and at age 60 is having problems. He isn’t overweight either.

Type 1 diabetes is an auto-immune disorder and one dies without insulin. There is no low-carb diet that works because without insulin your body cannot get glucose into cells and you eventually “starve” to death while still eating normally. If you are a Type 1 making no insulin, it takes less than a week for this to happen no matter what you eat.
Yes, many foods have added sugar. One can read the label and either incorporate it into their diet or make their own foods at home. Any good diabetes educator will inform the patient of this. If they don’t, they need their certification yanked.
One person will do fine on insulin for years, another suffer complications rapidly. The newer beliefs include include a genetic component. I was told that even “tight” control cannot in any way guarantee success. It’s all individual. Telling people that “tight” control will prevent complications is incorrect—it increases the odds you won’t get the complications, but just like people with normal lipids, great eating habits and daily exercise have been known to drop dead from a heart attack, diabetics who followed all the recommendations still develop complications and some who are brittle do very well for decades.

There are days, and reading this is one of them, where I think all the advances for diabetics that measure blood sugars, including the A1c are actually very, very bad for the general public. Now anyone can measure their blood sugar and immediately jump to whatever conclusion they like concerning causes and whether or not the result is good or bad. There are studies of blood sugar in non-diaabetics but they are very small and very short. As far as I can tell, science really does not know how much people’s blood sugars fluctuate and whether or not that is good or bad. Yet there is an insistence on claiming science does and trying to dictate policy based on that non-existent knowledge. Blood sugars should never fluctuate according to much of science, but in the real world, no one knows. Those meters just gave us numbers, not many of them, and not knowledge.

Epilogue:
First, my thanks to all who have spent some of their precious time reading this essay on The Sugar Wars. Special thanks to all those who made the effort to comment – and top marks to those who did so in an effort to discuss and better understand the theme of the essay — The Sugar Wars as an example of Modern Scientific Controversy (MSC).
As I learned in the two earlier essays in this series –“If you mention it, they will fight it”. Any mention of these hot topic controversies brings out the combatants — or brings out the combatant in each of us — ready to fight for the right as we see it. If the actual facts of the matter were easily known and clearly explained in some easy to understand book, there would be no controversy.
One of the major factors that has surfaced in my investigation of MSCs is that the topics involve complex, complicated, intertwined science that interfaces with issues that are polarized in civil society (outside of the science). In this case, the civil issue is the human diet and its effect on human health. The science-policy interface of Nutritional Science has been muddied over the years by a series of public policy campaigns that have turned out, as science advanced to better understanding, to have been not only wrong, but possibly harmful. Simply put, Nutritional Science has poisoned itself. And it has not yet recovered.
Thanks for reading.
Readers who have further questions can always email me at my first name at the domain i4 decimal net.

I studied sugar because I was tired of people telling me things like, Honey is good for you, but Agave is bad and High Fructose is bad, and Coke with sucrose is better for you than Coke with Hi Fructose. So I simplified figured out exactly what these things are.
Sucrose, table sugar is essentially 50% glucose 50% fructose. The glucose part immediately raises your blood sugar levels because it passes right into your blood stream and is the source of sugar the body uses as energy.
Anything higher than about 60% fructose is called high fructose sugar, usually the called corn syrup. Corn syrup is corn starch with alpha amylase, (the enzyme in your saliva that makes a saltine get sweet if you hold it in your mouth). That turns the starch into fructose and glucose.
Honey is mostly very high fructose syrup! It also has tiny amounts of maltose and ash from bee vomit.
Agave syrup is really not much different. Just no vomit.
So what’s the difference? None are good or bad.
The glucose part of the sugar can go right into your bloodstream, whereby the fructose needs the liver to process it. So high fructose raises your blood sugar slower, which has its benefits if you’re worried about blood sugar spikes.
The draw backs to high fructose are a few. Some people don’t get satiated because their blood sugar does not rise as fast, so they end up consuming more of the soda. Another not so good thing is that whatever fructose the liver cannot process turns into triglycerides!

@ Bob Johnston
July 19, 2016 at 10:18 pm
I agree heartily on Web MD. I once contacted the editor to protest about a dangerous oversimplification regarding ways of reliably neutralizing parasites in seafood, and got the bum’s rush.
I wasn’t aware of some of the information in your comment, and appreciate it, but I’ve noted some other glaring defects in the Original Post:
1. the characterization of “almost all” anti-sugar advocates as raving paranoiacs:
“In the War on Sugar, we find almost exclusively a large monolithic body of science and health researchers, ‘science popularizers’ and government agencies…[who] assert that there is a conspiracy called Big Sugar (which includes all food producers and anyone else not aligned with their view).”
2. The invocation of the BMI, one of the bluntest tools in the medical bag, and unscientific pontification “it is well established that”:
“It is well established that the morbidly obese – those with body mass indexes exceeding 35 or so – are prone to a bevy of health problems which include diabetes and cardiovascular problems associated with high blood pressure. ….”
(full disclosure – my own fat density measured recently at 8% by the gold standard imaging technique, and yet I have a BMI in the low 30s)
3. And the failure to clarify the most puzzling aspect of the sugar indictment – that “natural” sugars are OK, only the processed ones are a danger to human health. It’s obvious to me that brown and black bears manage to get very, very fat by gorging themselves on berry sugars in the Fall, and manage that without ever consuming processed sugars. So I would deduce that a human being consuming the same quantity of fruit would get just as fat.
And why don’t the bears suffer from diabetes and cardio-vascular disease?
As for other scientific “wars” deserving to be pacified – I would suggest the War on Radon. It is based on an unscientific assumption by the EPA, the WHO, and Health Canada, among others, that the toxicity of Radon daughters is linear, and totally ignores the concept of hormesis, well known and accepted (sometimes very belatedly) in the case of other trace elements in our environment, such a selenium.
I have not been able to get access to the original studies, but have read that experiments with lab mice in the 1950’s demonstrated that those that had all Radon removed from their food, water, and air lived only 66% as long as the control group.
It has also been reported in the mass media that people suffering from serious osteoarthritic pain reported being relieved of their pain for several months after spending a few hours in decommissioned mines having high levels of Radon. I’ve not been able to get access to any of the scientific reports on that either. But have seen video documentaries suggesting that such visits have been commercially organized and regularly scheduled in the past.

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